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Monday, February 28, 2011

Fast-Fighting Fever with Medication Not Always Beneficial For Children

Fast-Fighting Fever with Medication Not Always Beneficial For ChildrenParents often reach for medication too quickly when their children develop fever. A new report from the American Academy of Pediatrics (AAP) recently published in the journal Pediatricssuggests that intervention is not necessary for fevers alone. 
According to lead author Dr. Janice Sullivan, “The focus should be on comfort and not on absolute temperature.” The onset of fever is the body’s way of fighting off illness by jump-starting the immune system and slowing the progression of bacteria and virus growth. Sullivan acknowledged that these benefits provided by fever “may shorten the time that your child remains ill.” Parents need to be aware that although fever is an indication that a child is ill, a visit to the family doctor may not be necessary unless there are accompanying symptoms such as lethargy, pain or dehydration.

The report included the first guidelines to be released by the AAP for the treatment of fever with over-the-counter medications. The authors emphasized that the primary goal in treating fever is to improve overall comfort level comfort level of the child.

According to the guidelines, this is best achieved with the use of fever-reducing drugs such as acetaminophen (Tylenol) or ibuprofen (Motrin and Advil). The recommended dosage for acetaminophen is 10 to 15 mg/kg every 4 to 6 hours, and 10 mg/kg for ibuprofen.

The researchers pointed out that existing evidence shows no difference in effectiveness between ibuprofen and acetaminophen for the reduction of fever symptoms, although some evidence shows that a combination of the two products given in alternate doses may be beneficial. However, the researchers warned that adverse effects may be associated with this regimen and that it is more confusing for parents to administer.

Caution is advised even when given separately, as both drugs are known to have rare side effects. Ibuprofen may carry a risk of being toxic to kidney cells (nephrotoxicity), particularly among children suffering from dehydration or complex medical illnesses. Similarly, acetaminophen can cause chemical-driven liver damage (Hepatotoxicity) in association with acute overdose. Hepatitis may also develop from chronic overdose stemming from a build up of the medication in the body due to regular dosages given over long periods of time.

To avoid overdosing children with fever-reducing medications, the guidelines remind parents to use proper dosing techniques. Dosage is determined by weight, not age or height. In addition, when giving a child fever-reducing medication, use the correct dosing devices, and not kitchen teaspoons, since they vary widely in size, and can lead to both over-treatment and under-treatment.

Parents are also advised not to wake children to administer medication. Sullivan said, “We discourage parents from waking their children to give them antipyretics (fever-reducing medications), because if their child is sleeping, there's no sign of discomfort.”

Parents are encouraged not to give their children cough or cold medicine that includes acetaminophen or ibuprofen in addition to administering fever-reducing medications. Sullivan noted that parents are often unaware that the drugs are among the ingredients in cough syrups, and wind up double-dosing their children with fever reducer. As an alternative to the use of drugs for the reduction of fever, parents can also try treating childhood fevers naturally.

Although fever alone need not be cause for alarm, parents are advised to closely monitor their children for signs of serious illness, and to be sure to keep their children properly hydrated. If your child continues to worsen, contact your pediatrician.


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