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Do not use paracetamol just to reduce fever, says NICE

By News team

Advice on the use of paracetamol and ibuprofen to treat feverish illness in children less than five years of age has been overhauled and the relationship between heart rate and fever in predicting serious illness highlighted, in an updated clinical guideline published by the National Institute for Health and Care Excellence today (22 May 2013).

The recommends that paracetamol or ibuprofen be considered when a feverish child is in distress, but not for the sole purpose of reducing body temperature. When using either medicine in children with fever it states:

  1. Continue only as long as the child appears distressed
  2. Consider changing to the other agent if the child’s distress is not alleviated
  3. Do not give both agents simultaneously
  4. Only consider alternating these agents if the distress persists or recurs before the next dose is due

Martin Richardson, consultant paediatrician and chairman of the guideline development group, said the section on the treatment of fever has been rewritten to encourage rational, stepwise use of drugs such as paracetamol and ibuprofen. Additionally, NICE said that one of the main priorities of the guideline is to get healthcare professionals to recognise that children with tachycardia are in at least an intermediate-risk group for serious illness.

"Potentially serious cases of feverish illness are likely to be rare, so it is important that information is in place to help healthcare professionals distinguish these from mild cases. This guideline will help doctors, nurses, pharmacists and other healthcare professionals to pick up the high-risk symptoms that indicate a child needs urgent medical attention," said professor Mark Baker, director of the Centre for Clinical Practice at NICE.

Citation: Electronicjuice DOI: 10.1211/PJ.2013.11121588

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