Monitoring for signs of serious illness, improving the child's comfort, and educating parents on medication use are key components of fever management.
Fever in a child is one of the most common clinical symptoms managed by pediatricians and other health care providers, and is a frequent cause of parental concern. In a clinical report published in Pediatrics, the American Academy of Pediatrics provides guidance for parents and families about how to best manage fever.
According to authors Janice E. Sullivan, MD, and Henry C. Farrar, MD, of the AAP Section on Clinical Pharmacology and Therapeutics, and Committee on Drugs, fever is not the primary illness but is a physiologic mechanism that has beneficial effects in fighting infection. There is no evidence that fever itself worsens the course of an illness or that it causes long-term neurologic complications.
Although many parents administer antipyretics such as acetaminophen or ibuprofen to a child to reduce fever, the report emphasizes that the primary goal should be to help the child feel more comfortable, rather than to maintain a “normal” temperature.
Current evidence suggests that there is no significant difference in the safety and effectiveness of acetaminophen and ibuprofen in the care of a generally healthy child with fever. There is evidence that combining these two products is more effective than the use of a single agent alone; however, there are concerns that combined treatment may be more complicated and contribute to the unsafe use of these drugs, wrote Sullivan and Farrar. As with all drugs, they should be used cautiously to minimize the risk of adverse drug effects and toxicity.
Other guidelines for pediatricians and other providers who treat children with fever include the following:
Finally, it is important that parents are instructed not wake up a sleeping child to administer a fever-reducer.
To access the Pediatrics report, click here.