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Acetaminophen Makes No Difference for Kids in the ICU

Acetaminophen treatment is a mainstay for pediatric fever, but this hospital-based study found it did not speed recovery or improve survival for sick kids.

Doctors frequently prescribe acetaminophen to children who develop a fever over 100 degrees Fahrenheit while they are in an intensive care unit. The thought is that by lowering their temperature, such patients will recover faster.

Does Acetaminophen Speed Recovery from Infection?

Australian and New Zealand physicians tested this theory. They randomly assigned 700 hospitalized ICU pediatric patients with a fever to receive acetaminophen or placebo every six hours. At the end of a month there was no difference between the acetaminophen group and the placebo group in terms of how long they stayed in the ICU or how likely they were to survive.

The investigators conclude:

“Early administration of acetaminophen to treat fever due to probable infection did not affect the number of ICU-free days.”

New England Journal of Medicine, Dec. 3, 2015

Now, these were very sick youngsters. Does this research have any meaning for parents concerned about a child with a cold and a fever? After all, acetaminophen (aka paracetamol outside the US) is usually the medication recommended to treat a young child’s fever, since aspirin could trigger Reye’s syndrome in a child with chickenpox or influenza.

There have been concerns about the possible consequences of acetaminophen use, however. Four years ago, an analysis published in Pediatrics (Dec. 1, 2011) urged parents in families with asthma to avoid using acetaminophen.

Although a sudden spike in fever could cause a seizure, parents have been urged to rely less on the thermometer and more on a child’s other symptoms as a sign of how the illness is progressing.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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