Two to 5 percent of young children have febrile seizures, and 30 percent of children have a recurrent seizure. Although previous studies have proved that ibuprofen and acetaminophen reduce fever in children, these studies have excluded children with a history of febrile seizure. Van Esch and colleagues compared the antipyretic efficacy of ibuprofen and acetaminophen in children with a history of febrile seizure.
The study included 70 children with a history of febrile seizure who had a rectal temperature of 38.5[degrees]C (101.3[degrees]F) on presentation. The children ranged in age from 10 months to four years (mean age: 2.1 years). Children received either acetaminophen syrup (10 mg per kg per dose) or ibuprofen syrup (5 mg per kg per dose). Medication was given every six hours for one to three days, depending on the duration of the febrile illness.
Four hours after the initial dose, ibuprofen reduced fever 0.50[degrees]C more than did acetaminophen; this difference was statistically significant. During the overall treatment, ibuprofen lowered the mean initial temperature from 39.1[degrees]C (102.4[degrees]F) to a mean temperature of 37.7[degrees]C (99.9[degrees]F); acetaminophen lowered the temperature from 39.2[degrees]C (102.6[degrees]F) to 38.0[degrees]C (100.4[degrees]F). Adverse events, which did not differ significantly between the groups, included gastrointestinal complaints, exanthemas and insomnia.
The authors conclude that both ibuprofen and acetaminophen are effective antipyretic agents in children with a history of febrile seizure. Use of ibuprofen resulted in a greater reduction in temperature at four hours after ingestion. The authors call for further research to determine the value of these antipyretic agents in the prevention of recurrent febrile seizures. (Archives of Pediatrics and Adolescent Medicine, June 1995, vol.149, p.632.)
COPYRIGHT 1995 American Academy of Family Physicians
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