Intended for healthcare professionals

Rapid response to:

Research

Paracetamol plus ibuprofen for the treatment of fever in children (PITCH): randomised controlled trial

BMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a1302 (Published 02 September 2008) Cite this as: BMJ 2008;337:a1302

Rapid Response:

Paracetamol and Ibuprofen (or Dipyrone) 3 hours each

Family Physicians and Pediatricians in Brazil normally prescribe
Paracetamol plus Dipyrone (that has proved its safety here)or Ibuprofen
only when fever comes up before 6 hours since last dose of one of them.

But they're not used at the same time. We normally use only one, 3
hours each, IF fever comes up before the intervall between the doses of a
single one.

Fever is a normal reaction of the body and the main problem about it
is febrile seizure, that has been proved not to harm (febrile seizure is a
normal reaction of the body and does not impair cognition, neurological
development or any other neurological condition).

So, I agree with the colleagues when they use paracetamol as the
first choice and associate other drugs only in cases they are needed.

1. Febrile Seizures: Clinical Practice Guideline for the Long-term
Management of the Child With Simple Febrile Seizures. Pediatrics
2008;121;1281-1286. http://www.pediatrics.org/cgi/content/full/121/6/1281

2. Anthony Harnden. Editorial: Antipyretic treatment for feverish
young children in primary care. BMJ 2008; 337:a1409.
http://www.bmj.com/cgi/content/extract/337

3. Martin Richardson, Monica Lakhanpaul and on behalf of the
Guideline. Assessment and initial management of feverish illness in
children younger than 5 years:summary of NICE guidance. BMJ 2007;334;1163-
1164. http://bmj.com/cgi/content/full/334/7604/1163

4. Brazilian Cochrane Centre. Dipyrone for acute primary headaches.
Cochrane Database Syst Rev. 2007 Apr 18;(2):CD004842

Competing interests:
None declared

Competing interests: No competing interests

12 September 2008
Leonardo C M Savassi
Coordinator
Betim, Minas Gerais, Brazil
Medical Residence at Family Medicine