Alternating drugs best for lowering fever in kids

Alternating between acetaminophen (in painkillers such as Tylenol) and ibuprofen (for example, Advil) is better than sticking with either agent alone at bringing down a fever in a young child, a study shows.

The study involved 464 children, between 6 and 36 months of age, with a rectal temperature of at least 38.4 degrees Celsius who were randomized to receive acetaminophen (12.5 mg/kg per dose every 6 hours), ibuprofen (5 mg/kg per dose every 8 hours), or alternating doses of each drug (every 4 hours) for 3 days.

Treatment with the alternating regimen provided many benefits over the two types of single therapy, Dr. E. Michael Sarrell, from Tel Aviv University, and colleagues report in the Archives of Pediatrics and Adolescent Medicine.

The alternating regimen was associated with more rapid reduction of temperature, a lower average temperature, a drop in fever-reducing medication use, less stress, and less absenteeism from day care compared with the other treatments.

“This study is the first randomized, double-blind, controlled clinical trial to our knowledge to assess the safety and effectiveness of an alternating regimen of acetaminophen and ibuprofen against each agent alone in children aged 6 to 36 months,” the investigators comment. The results suggest that the alternating regimen is, in fact, superior to either agent alone, they conclude.

SOURCE: Archives of Pediatrics and Adolescent Medicine February 2006.

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