'Ibuprofen best' for child fevers Baby

Most symptoms of a fever in young children can be managed at home

Ibuprofen is better at alleviating childhood fever than paracetamol and should be the drug of first choice, say UK researchers.

The Bristol-based trial involving 156 children aged between six months and six years showed ibuprofen reduced temperature faster than paracetamol.

The British Medical Journal work also says alternating the two drugs could help, which some GPs already recommend.

But experts advised against this, in line with official guidance.

The concern is the relative ease with which children could receive an overdose.

Fever is very common in young children, affecting seven in every 10 preschool children each year.


Parents wanting to use medicines to treat young, unwell children with fever should be advised to use ibuprofen first
Lead researcher Dr Alastair Hay

It can be miserable for the child and cause anxiety for parents. Most fevers will settle by themselves but a few are caused by serious infections such as pneumonia.

Guidelines published last year by the National Institute for Health and Clinical Excellence (NICE) say either ibuprofen or paracetamol can be used for children unwell or distressed with fever.

But they say that, due to the lack of evidence, the two drugs should not be given together or alternated.

The researchers from the University of Bristol and the University of the West of England, recruited children who had a temperature between 37.8 and 41 degrees centigrade, due to an illness that could be managed at home.

Alternating drugs

Children were randomised to receive either paracetamol plus ibuprofen, just paracetamol, or just ibuprofen.

The medicines were given over a 48-hour period, with the group of children on both paracetamol and ibuprofen receiving them as separate doses.

This group received one dose of paracetamol every four to six hours (maximum of four doses in 24 hours) and then one dose of ibuprofen every six to eight hours (maximum of three doses in 24 hours).


Childhood fever
A normal temperature is between 36-36.8C (96.8-98.24F)
In children, any temperature of 38C (100.4F) or above is considered high and is called a fever
To find out if your child has a fever, place a thermometer under your child's armpit or use a special ear thermometer

The children's condition was followed up at 24 hours, 48 hours and at day five.

The researchers found that in the first four hours children given both medicines spent 55 minutes less time with fever compared to those given paracetamol alone.

But giving two medicines was not markedly better than just giving ibuprofen.

However, over a 24 hour period, children given both medicines experienced 4.4 hours less time with fever than those given just paracetamol, and 2.5 hours less time with fever than those just given ibuprofen.