- Fever is a frequent occurrence in young children, and provokes significant
anxiety in parents.2 It is a leading reason for seeking medical
care in both outpatient clinics and emergency rooms.3
- There is no consensus about when fever should be treated, or with
what drug or combination of drugs. Individual physicians recommend a
wide variety of treatment regimens to their patients.4
- The efficacy of combination antipyretic regimens alternating acetaminophen
and ibuprofen has not been tested; however, they are frequently recommended
- Parents frequently make errors in dosing antipyretics at home. In
single-dose regimens, parents gave erroneous doses 50% of the time.5
- Both acetaminophen and ibuprofen have well-documented toxicities in
- Ibuprofen and acetaminophen dosing and timing are different, leading
to additional confusion in regimens alternating the two drugs. Many
regimens combining the two exceed the recommended total daily dose of
acetaminophen even when followed correctly.4
Anthony et al. Antipyretic Effects of Dipyrone Versus Ibuprofen Versus
Acetaminophen in Children: Results of a Multinational, Randomized, Modified
Double-Blind Study. Clinical Pediatrics 2001;40:313-324.
MS, Naimatk L, Leduc DG, Parental Fever Phobia and its correlates. Pediatrics
P. Fever. Pediatrics in Review 1998; 19:401-407.
CE, Marino RV, Rosenfeld W, Greensher J. Alternating Antipyretics: Is
this an alternative? Pediatrics 2000; 105:1009-1012.
- Li SF,
Lacher B, Crain EF. Acetaminophen and ibuprofen dosing by parents. Pediatric
Emergency Care 2000; 16(6):394-397.