infectious diseases
Fever
Treatment of Fever
Specific causes of fever are treated with anti-infective therapy. Empiric anti-infective therapy that is based on the most likely anatomic site and the pathogens involved is required when suspicion of serious infection is high taking into account the potential risk that infection involves a multidrug-resistant bacterial pathogen. Whether fever due to infection should be treated with antipyretics is controversial. Experimental evidence, but not clinical studies, suggests that fever enhances host defenses. Fever should probably be treated in certain patients at particular risk, including adults with cardiac or pulmonary insufficiency or with dementia. Drugs that inhibit brain cyclooxygenase effectively reduce fever: Acetaminophen650 to 1000 mg orally every 6 hours Ibuprofen400 to 600 mg orally every 6 hours The daily dose ofacetaminophenshould not exceed 4 g to avoid toxicity; patients should be warned not to simultaneously take nonprescription cold or flu remedies that containacetaminophen. Other nonsteroidal anti-inflammatory drugs (eg,aspirin,naproxen) are also effective antipyretics. Salicylates should not be used to treat fever in children with viral illnesses because use has been associated with Reye syndrome. If temperature is≥41°C, other cooling measures (eg, evaporative cooling with tepid water mist, cooling blankets) should also be started. 