No significant difference in risk from paracetamol [1, 40, 41] Increased risk of asthma-related find more outpatient attendance in children with asthma  May be preferable for children
with asthma (but without aspirin-sensitive asthma) May be preferable for children with chicken pox Risk of severe cutaneous complications in patients with varicella or herpes zoster  Risk of hepatotoxicity—potentially serious, but rare [1, 88] May be preferable where there is a risk of dosing error or confusion May be preferable for children who are dehydrated or with pre-existing renal disease or multi-organ failure Risk of renal toxicity—potentially serious, but rare  aDifferent routes of administration may be used for pediatric fever in hospitalized patients Interestingly, despite equal recommendation in guidelines, there Selleckchem Go6983 is evidence to suggest that paracetamol is the ‘favored’ antipyretic medication for home management of pediatric fever . The reasons for this apparent discrepancy are unclear, although over-the-counter (OTC) paracetamol has been available for longer than ibuprofen, and brand names such as Calpol and Tylenol are consequently firmly established in the minds of parents. This familiarity can present advantages
(rapid access when required) and disadvantages Fedratinib nmr (resistance to change). There may also be perceptions, for both parents and HCPs, around relative safety and efficacy. This narrative literature review of recent data aims to determine whether there are any clinically Monoiodotyrosine relevant differences in efficacy and safety between ibuprofen and paracetamol that may recommend one agent over the other in the management of the distressed,
feverish child. In addition, it also explores why there is a discrepancy between current guidelines and the real-world use of these treatments. 2 To Treat or Not to Treat Before discussing treatment, it is important to consider what constitutes ‘distress’ and how parents interpret this term . Perception of distress is likely to vary markedly between parents, and may be linked to factors such as level of education, socioeconomic status and cultural background [13–15]. This may impact on when a parent decides to start treating their child with an antipyretic, whether to change antipyretics, or indeed when to consult an HCP. The problem of defining distress is recognized in the NICE guidelines, and the Guideline Development Group has called for studies on home-based antipyretic use and parental perception of distress caused by fever in order to clarify issues such as triggers for antipyretic use and help-seeking behavior .