Objective:To compare the antipyretic benefit of acetaminophen or ibuprofen mo notherapy with an alternating regimen of both drugs in young children aged 6 to 36 months.Design:Randomized,double-blind,parallel-group tri...Objective:To compare the antipyretic benefit of acetaminophen or ibuprofen mo notherapy with an alternating regimen of both drugs in young children aged 6 to 36 months.Design:Randomized,double-blind,parallel-group trial.Setting:Th ree primary pediatric community ambulatory centers in central Israel.Participan ts:A total of 464 children aged 6 to 36 months with fever.Intervention:Infant s were assigned to receive either acetaminophen(12.5 mg/kg per dose every 6 hou rs)(n=154)or ibuprofen(5 mg/kg per dose every 8 hours)(n=155)or to receive alternating acetaminophen and ibuprofen(every 4 hours)(n=155)for 3 days after a loading dose.Main Outcome Measures:Temperature,stress score,amount of ant ipyretic received,total days that the infant or caregiver was absent from day c are or work,respectively,at the 3-day time point,recurrence of fever,and nu mber of emergency department visits.Results:The group given the alternating re gimen was characterized by a lower mean temperature,more rapid reduction of fev er,receiving less antipyretic medication,less stress,and less absenteeism fro m day care as compared with the other groups;all of the differences were statis tically significant(P < 0.001).None of the regimens were associated with a sig nificantly higher number of emergency department visits(P=.65)or serious long-term complications(P=.66).The drug used for initial loading had no effect on outcome in any of the groups.Conclusions:An alternating treatment regimen of acetaminophen(12.5 mg/kg per dose)and ibuprofen(5 mg/kg per dose)every 4 hou rs for 3 days,regardless of the initial loading medication,is more effective t han monotherapy in lowering fever in infants and children.展开更多
文摘Objective:To compare the antipyretic benefit of acetaminophen or ibuprofen mo notherapy with an alternating regimen of both drugs in young children aged 6 to 36 months.Design:Randomized,double-blind,parallel-group trial.Setting:Th ree primary pediatric community ambulatory centers in central Israel.Participan ts:A total of 464 children aged 6 to 36 months with fever.Intervention:Infant s were assigned to receive either acetaminophen(12.5 mg/kg per dose every 6 hou rs)(n=154)or ibuprofen(5 mg/kg per dose every 8 hours)(n=155)or to receive alternating acetaminophen and ibuprofen(every 4 hours)(n=155)for 3 days after a loading dose.Main Outcome Measures:Temperature,stress score,amount of ant ipyretic received,total days that the infant or caregiver was absent from day c are or work,respectively,at the 3-day time point,recurrence of fever,and nu mber of emergency department visits.Results:The group given the alternating re gimen was characterized by a lower mean temperature,more rapid reduction of fev er,receiving less antipyretic medication,less stress,and less absenteeism fro m day care as compared with the other groups;all of the differences were statis tically significant(P < 0.001).None of the regimens were associated with a sig nificantly higher number of emergency department visits(P=.65)or serious long-term complications(P=.66).The drug used for initial loading had no effect on outcome in any of the groups.Conclusions:An alternating treatment regimen of acetaminophen(12.5 mg/kg per dose)and ibuprofen(5 mg/kg per dose)every 4 hou rs for 3 days,regardless of the initial loading medication,is more effective t han monotherapy in lowering fever in infants and children.
