A5V4d

Feverish illness in children
majority of studies used paracetamol (acetaminophen), with aspirin being used when paracetamol
had already been administered (this reflects the age and setting of the studies as this is not
acceptable practice in the UK). The dosage of paracetamol used was either 10 or 15 mg/kg. The age
of children ranged up to 17 years in one study, but the majority were 2 years or younger.
Evidence profile
The GRADE profiles presented show results of included studies for the review question. .
Table 8.5 GRADE findings of response to antipyretics by children with bacterial or non-bacterial illnesses.
Number of
studies
178
Number of children Effect Quality
Serious disease
( [SD], n)
Not serious
disease ( [SD],
n)
Final symptoms score – Yale Observation Score
Baker et
al, 1989
Relative
(95% confidence
interval) (MD and
Standardised MD)
(95% confidence
interval)
7.5, (+/- 1.4), n=15 7.7, (+/- 2.2), n=135 0.2 (NS) -
Change in symptoms – Yale Observation Score
Baker et
al, 1989
-3.8 (+/- 3.2), n=15 -1.6 (+/- 2.5), n=135 2.2 (P < 0.001) -
Change in temperature °C between serious and non-serious disease
Torrey et
al, 1984
Baker et
al, 1989
Yamamoto
et al, 1987
Mazur et
al, 1989
Weisse et
al, 1987
Baker et
al, 1987
Mazur et
al, 1994
Bonadio et
al, 1993
-1.32, - , n=16 -1.05, - , n=239 0.27 (P = 0.14) -
-1.7, (+/- 0.8),
n=15
-1.606 (+/- 0.722),
n=17
-1.0 (+/- 0.6),
N=34
-1.6, (+/- 0.6), n=135 SMD -0.16 (-0.69 to
+0.37)
-1.639 (+/- 0.705),
N=216
-1.5 (+/- 0.5),
N=68
SMD 0.05 (-0.45 to
+0.54)
SMD 0.92 (0.49 to
1.36)
Absolute
mean
difference
-
Very
low
Very
low
Very
low
Very
low
- Very
low
- Very
low
1.48°F, -, n=17 1.16°F, -, 1n=6 0.32°F (P = 0.37) - Very
low
1.3 (+/- 0.8), n= 62 1.0 (+/- 0.6), n= 234 SMD -0.46 (-0.75 to
-0.18)
P < 0.01 against all
groups
-1.0, (+/- 0.6, n=34 -1.2, (+/- 0.6), n=450 SMD -0.33 (-0.68 to
+0.02)
-1.40, -, n=59 -1.44, -, n=59 0.04 (NS) -
Final temperature C between serious and non-serious disease
-
Very
low
- Very
low
Very
low
2013 Update