A5V4d

Number of
studies
Torrey et
al, 1984
Baker et
al, 1989
Management by the paediatric specialist
Number of children Effect Quality
Serious disease
( [SD], n)
Not serious
disease ( [SD],
n)
Relative
(95% confidence
interval) (MD and
Standardised MD)
(95% confidence
interval)
Absolute
mean
difference
38.8, - , n=16 38.8, - , n=239 (P = 0.46) - Very
low
38.5 (SD +/- 0.6),
n=15
Change in febrile state
Yamamoto
et al, 1987
Mazur et
al, 1989
Weisse et
al, 1987
Mazur et
al, 1994
38.4 (SD +/- 0.6),
n=135
(NS)
SMD 0.17 (-0.37 to
+0.70)
- Very
low
15 of 17 180 of 216 RR 1.06 (0.88 to 1.27) - Very
low
18 of 34 62 of 68 Univariate OR = 9.2
(95% CI 2.7 to 32.0)
Multivariate OR = 9.4
(95% CI 2.6 to 34.2)
-
Very
low
4 of 35 10 of 65 RR 0.74 (0.25 to 2.20) - Very
low
18 of 34 335 of 450 RR 0.71 (0.52, 0.98)
Univariate OR = 2.6
(95% CI 1.3 to 5.2)
Multivariate OR = 3.4
(95% CI 1.6 to 7.3)
- Very
low
CI confidence interval, MD mean difference, NS non-significant, OR odds ratio, RR relative risk, SD standard deviation, SMD
standard mean difference
Evidence statements
One study found no difference in the Yale Observation Score between children with bacterial illness
and those without bacterial illness following treatment with antipyretics. However, the same study did
find a significant difference in the change in Yale Observation Score before and after treatment
between the groups. The evidence for this finding was of very low quality.
Three studies found that temperature was reduced more in children with bacterial illness compared
with children without bacterial illness after antipyretics were administered. Three other studies found
no difference in temperature reduction in children with bacterial illness compared with children without
bacterial illness after antipyretics (paracetamol or ibuprofen) were administered. A further two studies
that analysed the same dataset found temperature was reduced less in children with bacterial illness
compared with children without bacterial illness after antipyretics were administered. The quality of
evidence was very low.
Two separate studies that analysed the same dataset found that the proportion of children who
responded to antipyretics (paracetamol or ibuprofen) was lower in children with bacterial illness
compared with children without bacterial illness. Two other studies found no difference in the
proportion of children who responded to antipyretics. This evidence was very low quality.
Health economics profile
No health economic studies were identified and no health economic analysis was undertaken for this
question as it did not consider the effectiveness of alternative interventions.
179
2013 Update