Ibuprofen first may be best for kids' fever

NEW YORK (Reuters Health) - The optimal method of reducing fever in children is to start with ibuprofen alone and then consider using paracetamol plus ibuprofen later, results of a new clinical trial suggest.

Ibuprofen is the ingredient in brand-name products like Advil or Motrin, while paracetamol -- called acetaminophen in many regions -- is found in Tylenol, for example. Both ibuprofen and paracetamol are widely available as generic products.

As reported in the British Medical Journal, Dr. Alastair D. Hay, from the University of Bristol, UK, and colleagues assessed the duration of fever in 146 children, between 6 months and 6 years of age, who were randomly assigned to get ibuprofen, paracetamol, or both for a high temperature.

In the first 4 hours after treatment, the drug combination cut the duration of fever by about 55 minutes compared with paracetamol alone. Ibuprofen alone was comparable to the combined therapy.

Over 24 hours, paracetamol plus ibuprofen reduced the fever duration by 4.4 hours relative to paracetamol alone and by 2.5 hours compared to ibuprofen alone.

Side effects were comparable with each treatment.

The authors of the report conclude: "Doctors, nurses, pharmacists, and parents wanting to use medicines to treat young, unwell children with fever should be advised to use ibuprofen first and to consider the relative benefits and risks of using paracetamol plus ibuprofen over a 24 hour period."

SOURCE: British Medical Journal, Online First, September 3, 2008.