Effectiveness of paracetamol versus ibuprofen administration in febrile children: A systematic literature review

@article{Narayan2017EffectivenessOP,
  title={Effectiveness of paracetamol versus ibuprofen administration in febrile children: A systematic literature review},
  author={Kaajal Narayan and Simon Cooper and Julia Morphet and Kelli Innes},
  journal={Journal of Paediatrics and Child Health},
  year={2017},
  volume={53}
}
The use of antipyretics to manage the febrile child is becoming increasingly popular. Paracetamol and ibuprofen are the most commonly used interventions to manage fever in children; however, there have been no comparative analyses. The aim of the study is to evaluate the evidence comparing paracetamol to ibuprofen in the treatment of fever in children. 
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References

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A randomised open label study of the combined use of paracetamol and ibuprofen to rapidly reduce fever is reported. The advantage of using both medications is less than half a degree centigrade in
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TLDR
A literature search of randomised controlled trials carried out to identify which, if either, of these drugs is faster at reducing a fever found ibuprofen to be marginally more effective than paracetamol.
Paracetamol plus ibuprofen reduced fever in young children faster than paracetamol alone but not ibuprofen alone
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Paracetamol plus ibuprofen reduced fever in young children faster than paracetamol alone but not ibuprofen alone
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To review the literature on the pharmacology and pharmacokinetics of paracetamol and ibuprofen pertaining to their use for paediatric pain and fever.
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TLDR
Based on the present results, ibuprofen-arginine oral drops have shown to be a safe, well-tolerated and potent paediatric antipyretic agent and should be considered as an adequate choice for the control of paediatric fever of likely infectious aetiology.
Effectiveness and tolerability of ibuprofen‐arginine versus paracetamol in children with fever of likely infectious origin
TLDR
Overall efficacy was judged from the recovery or improvement in 68.8% of patients in the ibuprofen‐arginine group compared with 65.5% in the paracetamol group, although this was not statistically significant, a trend towards improved activity was observed.
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TLDR
The use of paracetamol in therapeutic doses generally is safe, although hepatotoxicity has occurred with recommended dosages in children and in developing countries where malnutrition is common, data on the safety of par acetamol are lacking.
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TLDR
Trial evidence that paracetamol has a superior antipyretic effect than placebo is inconclusive and there is insufficient evidence to show whether par acetamol influenced the risk of febrile convulsions.
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TLDR
Parents, nurses, pharmacists, and doctors wanting to use medicines to supplement physical measures to maximise the time that children spend without fever should use ibuprofen first and consider the relative benefits and risks of using paracetamol plus ib uprofen over 24 hours.
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TLDR
Trial evidence that paracetamol has a superior antipyretic effect than placebo is inconclusive and there is insufficient evidence to show whether par acetamol influenced the risk of febrile convulsions.
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