MINIMUM DOSE FOR CHILDREN WITH FEVER, PARENTS ADVISED

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MINIMUM DOSE FOR CHILDREN WITH FEVER, PARENTS ADVISED
27 March 2007 - University of Bristol

Parents should be advised to use the minimum dose necessary when treating a child with fever, say researchers from the University of Bristol in the British Medical Journal.

Fever is common in children and can often cause distress, parental anxiety, and, in some parents, “fever phobia” (undue fear of the effects of fever ).

Non-drug treatments include loosening clothing, reducing the ambient temperature, and encouraging the child to take fluids. The drug options are paracetamol and ibuprofen, and parents commonly give both drugs to a child with fever.

But should these drugs be used together, or alternately? For which children, and at what dose and frequency? Advice is inconsistent, leading to confusion and frustration among parents, nurses, and doctors.

To try to answer these questions, researchers at Bristol University, the University of West of England and the University of Bath searched the scientific literature, but found very little evidence to support prescribing paracetamol and ibuprofen in combination or alternately.

They also found other important gaps in the evidence, including limited safety data and no clear definition of what is a clinically important temperature difference after treatment.

Until such evidence is available, the role of combined anti-fever drugs is uncertain, they warn.

Dr Alastair Hay, a GP in Bristol and the lead researcher at the University of Bristol said: “This paper highlights the need for more research to help parents, nurses and doctors decide whether two medicines are really better than one. This is exactly what the PITCH fever study, currently being conducted in the Bristol area is doing.

Given that the absence of evidence from trials is at odds with strongly held parental beliefs in many cases, and given the desire among parents and clinicians to do something when faced with febrile children, it seems churlish to conclude that combined treatment should be withheld from all children, say the authors.

But parents should be advised to use the minimum treatment necessary, they conclude.

“This paper highlights the need for more research to help parents, nurses and doctors decide whether two medicines are really better than one."

http://www.bris.ac.uk

About: University of Bristol
The University College of Bristol opened in 1876, after six years of discussions and controversy, in a bid to bring university culture to the provinces. It was the first college in the country to admit men and women on an equal footing.

The University’s Research and Enterprise Development (RED) division was launched in 2000 to stimulate and support an entrepreneurial culture and encourage the growth of technology-based business.

2003 saw the completion of the Dorothy Hodgkin building, named after the University’s fifth Chancellor. The £18 million building is dedicated to research in neuroendocrinology. 2003 also saw the opening of the University’s £5 million Centre for Sport, Exercise and Health.

Work on a new, state-of-the-art engineering building is due to be completed in early 2004. The £20 million BLADE project (Bristol Laboratory for Advanced Dynamics Engineering) will bring together the Engineering Faculty’s six departments to establish Europe’s most advanced dynamics engineering research facilities.

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