Acetaminophen and Febrile Seizure Recurrences During the Same Fever Episode

Pediatrics. 2018 Nov;142(5):e20181009. doi: 10.1542/peds.2018-1009. Epub 2018 Oct 8.


Objectives: To confirm the safety of using acetaminophen for febrile seizures (FSs) and to assess its efficacy in preventing FS recurrence during the same fever episode.

Methods: In this single-center, prospective, open, randomized controlled study, we included children and infants (age range: 6-60 months) with FSs who visited our hospital between May 1, 2015, and April 30, 2017. The effectiveness of acetaminophen was examined by comparing the recurrence rates of patients in whom rectal acetaminophen (10 mg/kg) was administered every 6 hours until 24 hours after the first convulsion (if the fever remained >38.0°C) to the rates of patients in whom no antipyretics were administered. No placebo was administered to controls. The primary outcome measure was FS recurrence during the same fever episode.

Results: We evaluated 423 patients; of these, 219 were in the rectal acetaminophen group, and 204 were in the no antipyretics group. In the univariate analysis, the FS recurrence rate was significantly lower in the rectal acetaminophen group (9.1%) than in the no antipyretics group (23.5%; P < .001). Among the variables in the final multiple logistic regression analysis, rectal acetaminophen use was the largest contributor to the prevention of FS recurrence during the same fever episode (odds ratio: 5.6; 95% confidence interval: 2.3-13.3).

Conclusions: Acetaminophen is a safe antipyretic against FSs and has the potential to prevent FS recurrence during the same fever episode.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acetaminophen / therapeutic use*
  • Administration, Rectal
  • Antipyretics / therapeutic use*
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Logistic Models
  • Male
  • Prospective Studies
  • Recurrence
  • Seizures, Febrile / drug therapy*
  • Treatment Outcome


  • Antipyretics
  • Acetaminophen

Associated data

  • UMIN-CTR/UMIN000028272