The use of antipyretics is controve

The use of antipyretics is controversial.
Historically, children with fever were routinely
given medication that reduced their
temperature effectively. However, the
long-term effect of this is unclear and there is
an increasing body of evidence suggesting
that fever is necessary for the immune system
to develop (NICE 2013). Together with the
risks of overdosing and long-term liver
damage, NICE (2013) recommends that
antipyretics should only be given when the
child is distressed and not with the sole
intention of reducing body temperature. The
guideline also recommends that only one
agent, either paracetamol or ibuprofen,
should be given and the use of the other agent
should only be considered if the child’s
discomfort persists before the next dose is due
(NICE 2013). Recommendations for the use
of antipyretics are shown in Box 1.
Complete time out activity 4
Febrile convulsions
Parents may be particularly concerned about
the possibility of febrile convulsions or seizures,
especially if their child has had a previous
episode (McIntyre 2011). However, there is
no evidence that antipyretics reduce the risk of
subsequent febrile seizures (El-Radhi and Barry
2003). Parents should be informed that febrile
seizures are common and that the risk of brain
damage and epilepsy are rare (Waruiru and
Appleton 2004).