Question 2: Does a failure to respond to antipyretics predict serious illness in children with a fever?

@article{King2013Question2D,
  title={Question 2: Does a failure to respond to antipyretics predict serious illness in children with a fever?},
  author={David Anthony King},
  journal={Archives of Disease in Childhood},
  year={2013},
  volume={98},
  pages={644 - 646}
}
  • D. King
  • Published 11 July 2013
  • Medicine
  • Archives of Disease in Childhood
You are a senior house officer (SHO) working in a busy district general hospital. A 9-month-old boy is brought in by his parents with a fever of 2 days duration. There is no obvious focus but the child appears well. A urine dipstick is negative. When reviewing the child, the registrar is concerned to learn that the fever has not responded to paracetamol (acetaminophen). You wonder if there is any evidence that a febrile child is more likely to have a serious illness if their fever fails to… 
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Fever in Children: Pearls and Pitfalls Please share how this access benefits you. Your story matters

The epidemiology and measurement of fever, the meaning of fever and associated clinical signs in children of different ages and under special conditions are reviewed, including fever in children with cognitive impairment, recurrent fevers, and fever of unknown origin.

Fever in Children: Pearls and Pitfalls

The epidemiology and measurement of fever, the meaning of fever and associated clinical signs in children of different ages and under special conditions are reviewed, including fever in children with cognitive impairment, recurrent fevers, and fever of unknown origin.

Il sintomo febbre: l'interpretazione e la corretta gestione

Current evidence is shown on the role of fever, the most correct methods for its measurement, the reasonable use of drugs for the symptomatic control of fever and the approach to be followed in the management of fever in the child aged less than 5 years.

Fever response to ibuprofen in viral and bacterial childhood infections.

Paracetamol: a focus for the general pediatrician

Although frequently prescribed, the concept of “effect compartment concentration” and the possible co-factors that could cause toxicity at recommended doses are not familiar to all pediatricians and general practitioners.

References

SHOWING 1-10 OF 13 REFERENCES

Childhood fever: correlation of diagnosis with temperature response to acetaminophen.

Relationship of bacteremia to antipyretic therapy in febrile children

It is concluded that lack of fever response to antipyretics is not a clinical marker for bacteremia in children.

Temperature response to acetaminophen and risk of occult bacteremia: a case-control study.

Temperature response to antipyretic therapy in children: relationship to occult bacteremia.

Correlating Changes in Body Temperature With Infectious Outcome in Febrile Children Who Receive Acetaminophen

Highly febrile young children with and without invasive bacterial infections who receive a therapeutic dose of acetaminophen experience a significant temperature drop after 60 to 90 min but do not commonly defervesce to an afebrile state.

Diagnostic tests for occult bacteremia: temperature response to acetaminophen versus WBC count.

FPIN's Clinical Inquiries. Aspirin use in children for fever or viral syndromes.

Aspirin use in children younger than 19 years should be limited to diseases in which aspirin has a proven benefit, such as Kawasaki disease and the juvenile arthritides.

Fever response to acetaminophen in viral vs. bacterial infections.

There is no correlation between a child's fever response to acetaminophen and the etiology of the fever, and the difference was found to be statistically insignificant.

Paracetamol plus ibuprofen for the treatment of fever in children (PITCH): randomised controlled trial

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.

Severity of disease correlated with fever reduction in febrile infants.

It was concluded that clinical improvement with defervescence is not a reliable indicator of the presence of occult bacteremia, and routine administration of acetaminophen may interfere with the clinical evaluation by the physician.