pediatrics
Fever in Infants and Children
Treatment of Fever in Infants and Children
Treatment is directed at the underlying disorder. Fever in an otherwise healthy child does not necessarily require treatment. Although antipyretics can provide comfort, they do not change the course of an infection. In fact, fever is an integral part of the inflammatory response to infection and can help the child fight the infection. However, most clinicians use antipyretics to help alleviate discomfort and to reduce physiologic stresses in children who have cardiopulmonary disorders, neurologic disorders, or a history of febrile seizures. Antipyretic drugsthat are typically used include Acetaminophen Ibuprofen . A randomized drug trial comparing the two showed that these drugs in usual doses do not lead to worsening of existing asthma ( Treatment reference ). However, the question remains whether the use of these drugs during pregnancy or early childhood increases the risk of developing asthma. If used, the dosage of Nondrug approachesto fever include putting the child in a warm or tepid bath, using cool compresses, and undressing the child. Caregivers should be cautioned not to use a cold water bath, which is uncomfortable and which, by inducing shivering, may paradoxically elevate body temperature. As long as the temperature of the water is slightly cooler than the temperature of the child, a bath provides temporary relief. Wiping the body down with isopropyl alcohol should be strongly discouraged because alcohol can be absorbed through the skin and cause toxicity. Numerous folk remedies exist, ranging from the harmless (eg, putting onions or potatoes in socks) to the uncomfortable (eg, coining, Cupping ). 1.Sheehan WJ, Mauger DT, Paul IM, et al:Acetaminophenversusibuprofenin young children with mild persistent asthma.N Engl J Med375(7):619–630, 2016. doi: 10.1056/NEJMoa1515990 