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Clinical Pediatrics
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Tepid Sponging to Reduce Temperature in Febrile Children in a Tropical Climate

A.F. Mahar

Liverpool School of Tropical Medicine, Liverpool, England

S.J. Allen

Liverpool School of Tropical Medicine, Liverpool, England

P. Milligan

Liverpool School of Tropical Medicine, Liverpool, England

S. Suthumnirund

Children's Hospital, Phyathai, Bangkok, Thailand

T. Chotpitayasunondh

Children's Hospital, Phyathai, Bangkok, Thailand

A. Sabchareon

Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand

J.B.S. Coulter

Liverpool School of Tropical Medicine, Liverpool, England

The effectiveness of tepid sponging, in addition to antipyretic medication, in the reduction of temperature in febrile children living in a tropical environment, was assessed in a prospective, randomized, open trial. Seventy-five children aged between 6 and 53 months who attended the casualty department of the Children's Hospital, Bangkok, Thailand, with fever (rectal temperature ≥38.5°C) of presumed viral origin were randomized to receive either tepid sponging and oral paracetamol (sponged group) or paracetamol alone (control group). Rectal temperature and the occurrence of crying, irritability, and shivering were recorded over the following 2 hours. A greater and more rapid fall in mean rectal temperature occurred in the sponged group than in the control group. Temperature fell below 38.5°C sooner in children in the sponged group than in control children (P <0.001). At 60 minutes, 38 (95.0%) of the controls still had a temperature of 38.5°C or greater, compared with only 15 children (42.9%) in the sponged group (P<1x10-5). Crying was associated with sponging, but shivering and irritability occurred in only one child who was being sponged. It is concluded that tepid sponging, in addition to antipyretic medication, is clearly more effective than antipyretic medication alone in reducing temperature in febrile children living in a tropical climate.

Clinical Pediatrics, Vol. 33, No. 4, 227-231 (1994)
DOI: 10.1177/000992289403300407
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M. Woollard and K. Pitt
Antipyretic prehospital therapy for febrile convulsions: Does the treatment fit? A literature review
Health Education Journal, January 1, 2003; 62(1): 23 - 28.
[Abstract] [PDF]