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Alternating Antipyretics: Antipyretic Efficacy of Acetaminophen Versus Acetaminophen Alternated With Ibuprofen in Children

Department of Pediatrics, Madigan Army Medical Center, Tacoma, Washington

Peaches A. Richards, MD

Weed Army Community Hospital, Fort Irwin, California

Amy M. Thompson, MD

Department of Pediatrics, Madigan Army Medical Center, Tacoma, Washington

David P. Harper, MD

Department of Pediatric Hematology-Oncology, Walter Reed Army Medical Center, Tacoma, Washington

Mary P. Fairchok, MD

Department of Pediatrics, Madigan Army Medical Center, Tacoma, Washington, mary.fairchok{at}us.army.mil

Methods A prospective, randomized double-blind placebo control study comparing the efficacy of acetaminophen to acetaminophen alternated with ibuprofen in 38 healthy outpatient children 6 months to 6 years presenting to the outpatient clinic with fever >38°C was conducted. Temperatures were recorded at 0, 3, 4, 5, and 6 hours. Side effect diaries and parental perception of efficacy were filled out hourly by parents.

Results There were no significant differences in temperature between the 2 groups at times 0, 3, and 6 hours. The alternating group had significantly lower mean temperatures at both 4 hours (38.0°C vs 37.4°C; P = .05) and 5 hours (37.1°C vs 37.9°C; P = .0032). Parents did not perceive any difference in fever control between the groups.

Conclusions An alternating regimen of acetaminophen with ibuprofen significantly decreased fever at 4 and 5 hours compared with acetaminophen alone. However, parents did not perceive a difference in efficacy.

Key Words: fever • acetaminophen • ibuprofen • pediatric

This version was published on November 1, 2008

Clinical Pediatrics, Vol. 47, No. 9, 907-911 (2008)
DOI: 10.1177/0009922808319967


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