Antipyretic treatment for feverish young children in primary care

Fever is one of the main concerns that parents have when their child is unwell. Many parents believe fever is potentially harmful and worry about its height and duration. It is standard practice for health professionals to give advice about administering antipyretic drugs to children. The most commonly used drugs are paracetamol (acetaminophen) and ibuprofen. Because these drugs can be given at alternating intervals some doctors tell parents to use a combination of both drugs during the course of a febrile illness.

In the linked study (doi:10.1136/bmj.a1302), Hay and colleagues report a randomised controlled trial of paracetamol, ibuprofen, and a combination of the two drugs in 156 febrile children age 6 months to 6 years in primary care. The trial has two primary outcomes—time without fever in the first four hours and fever associated discomfort after 48 hours.1 Hollinghurst and colleagues compare the costs to parents and the NHS of the three drug regimes.2

The scale of childhood fever and treatment costs is large. …