Fever can, however, be a distressing symptom, causing pain, lethargy, rigors and irritability. In this setting it is very reason-able to want to control the temperature. Advice given to parents about the use of antipyrexials varies considerably. Both ibuprofen and paracetamol have been shown to be effective at managing temperature. Their use in combination is a little more controversial. Currently, there is no evidence that the combination of the two taken at the same time is of any benefit.13,14 However, there is limited data to suggest that using both drugs in alternation is
more effective then monotherapy.15 A sensible approach would be to use monotherapy as first-line as the use of two medications comes with a higher risk of medication error. If monotherapy fails to control the temperature one should attempt alternate-dose therapy.