Evidence on the use of paracetamol in febrile children

• Главные авторы: Russell Fiona M. (Автор), Shann Frank (Автор), Curtis Nigel (Автор), Mulholland Kim (Автор)
• Формат: ‌
• Опубликовано: The World Health Organization, 2003-01-01T00:00:00Z.
• Предметы: article
• Online-ссылка: Connect to this object online.
• Notes: 0042-9686
• Keywords: Acetaminophen/pharmacology; Fever/drug therapy; Child; Virus diseases/drug therapy; Bacterial infections/drug therapy; Malaria, Falciparum/drug therapy; Febrile seizures/drug therapy; Treatment outcome; Review literature; Meta-analysis; Public aspects of medicine; RA1-1270
• Source: Bulletin of the World Health Organization, Vol 81, Iss 5, Pp 367-372 (2003)

Antipyretics, including acetaminophen (paracetamol), are prescribed commonly in children with pyrexia, despite minimal evidence of a clinical benefit. A literature review was performed by searching Medline and the Cochrane databases for research papers on the efficacy of paracetamol in febrile illnesses in children and adverse outcomes related to the use of paracetamol. No studies showed any clear benefit for the use of paracetamol in therapeutic doses in febrile children with viral or bacterial infections or with malaria. Some studies suggested that fever may have a beneficial role in infection, although no definitive prospective studies in children have been done to prove this. The use of paracetamol in therapeutic doses generally is safe, although hepatotoxicity has occurred with recommended dosages in children. In developing countries where malnutrition is common, data on the safety of paracetamol are lacking. The cost of paracetamol for poor families is substantial. No evidence shows that it is beneficial to treat febrile children with paracetamol. Treatment should be given only to children who are in obvious discomfort and those with conditions known to be painful. The role of paracetamol in children with severe malaria or sepsis and in malnourished, febrile children needs to be clarified.