Does the use of antipyretics in children who have acute infections prolong febrile illness? A systematic review and meta-analysis

Abstract

Objective: To review the literature and test the hypothesis that the use of antipyretic drugs in children with acute infections slows recovery.

Study design: A systematic review and meta-analysis of the literature was undertaken to investigate the effect of antipyretic drugs upon recovery from infectious diseases in children. A search of Medline (1946 until November 2012) and EMBASE (1980 until November 1, 2012) was undertaken to identify studies in which the authors compared the use of antipyretic medications with nonpharmacologic treatments for fever.

Results: Six papers were identified, 5 of which were included in the meta-analysis. Three studies focused on children with malaria and the other 3 considered general viral and respiratory infections and varicella. The pooled mean difference in time to fever clearance was 4.16 hours and was faster in those receiving antipyretics compared with those not (95% CI -6.35 to -1.96 hours; P = .0002). There was little evidence of statistical heterogeneity (χ(2) 4.84; 4 df; P = .3; I(2) 17%).

Conclusion: There is no evidence from these studies that the use of antipyretics slows the resolution of fever in children.

Keywords: COX; Cyclooxygenase; IL; Interleukin; NSAID; Nonsteroidal anti-inflammatory drug; PGE(2); Prostaglandin E(2); RCT; Randomized controlled trial.