A5V4d

Number of
studies
1 (Lesko et
al., 2001)
1 (Lesko et
al., 2001)
1 (Lesko et
al., 2001)
Antipyretic interventions
Number of children Effect Quality
Antipyretic No
treatment
Ibuprofen
only
Acetaminop
hen only
Acetaminop
hen and
ibuprofen
No
medication
No
medication
Time to total scabbing using paracetamol
1 (Doran et
al., 1988)
6.7 days
(SD 2.3)
Relative
(95% confidence interval)
Matched OR 1.5 (0.58 to 11) a
Matched OR 0.98 (0.43 to 2.2) a ,
Adjusted OR 0.94 (0.34 to 2.6) a
Neither Matched OR 5.0 (1.6 to 16) a
5.6 days
(SD 2.5)
Adjusted OR 5.6 (1.2 to 25) a
P < 0.05 a
Time to last new vesicle using paracetamol
1 (Doran et
al., 1988)
3.9 days
(SD 1.4)
4.1 days
(SD 1.2)
Time to total healing using paracetamol
1 (Doran et
al., 1988)
16.1 (SD
5.6)
16.2 (SD
5.8)
P = 0.64 a
P = 0.45 a
Number of paracetamol doses used by parents
1
(Sugimura
et al.,
1994)
Complicated
pneumonia
2.52 (SD
0.80)
Pneumonia
1.37 (SD
0.72)
OR odds ratio, P probability, RR relative risk
P < 0.001 a
Absolute
(95% confidence
interval)
Note: Observational studies are set at low quality unless they have design aspects that increase this.
a As reported by authors.
Evidence statements
- Very
low
- Very
low
- Very
low
- Very
low
- Very
low
- Very
low
- Very
low
Two observational studies found higher rates of pneumonia with complications were associated with
use of ibuprofen. This finding was statistically significant. The evidence for this finding was of very low
quality, specifically because this type of study cannot confirm a causal link between use of ibuprofen
and complicated pneumonia. Patients with severe pneumonia might be more likely to have a high
fever and hence receive antipyretics.
One observational study found higher rates of group A streptococcal infection with the use of
ibuprofen or ibuprofen and paracetamol combined, but not with use of paracetamol alone. The
evidence for this finding was of very low quality.
Three observational studies found higher rates of varicella with skin complications associated with the
use of paracetamol. This finding was statistically significant. The evidence for this finding was of very
low quality. Again, this type of study cannot confirm a causal pathway between use of paracetamol
and varicella with complications.
One RCT study found that time to ‘scabbing’ was shorter in children with chickenpox who received
placebo compared with children who received paracetamol. This finding was statistically significant.
However, for two further outcomes (last new vesicle and total healing time) there was no statistical
association between paracetamol use and outcome. The evidence for these findings was of very low
quality.
195
2013 Update