Study: Ibuprofen better than acetaminophen for children's fevers

With the start of the school year, I'll wager that my preschool son will bring home a cold or throat infection in a week or two. A runny nose isn't a cause for concern, but a high temperature can make a child feel miserable. Like many parents, I keep two common fever remedies on hand: acetaminophen (Tylenol) and ibuprofen (Advil, Motrin). A new study has looked at which of these drugs works best to bring down children's fevers and whether taking both drugs together might be better than taking just one.

The study included about 150 children between 6 months and 6 years old. It found that ibuprofen worked faster and for longer than acetaminophen at reducing high temperatures. Taking both medicines together didn't seem to be any better than taking ibuprofen on its own, although children given both medicines might have had an extra couple of hours without a fever on the first day.

The study also found that it was very easy for parents to lose track when giving children two different medicines. Even in a study, where nurses often gave the first dose and parents were given careful advice, 31 children ended up being given more than the recommended amount. This is important, since overdoses of either acetaminophen or ibuprofen can be very dangerous.

What you need to know. A fever is one of the body's normal defenses against illness, and it may not need to be treated. If your child is playing, drinking fluids and not in distress, treatment is probably unnecessary.

But if your child is uncomfortable, you may want to use ibuprofen or acetaminophen to bring the fever down. Either medication can help, but ibuprofen may work best. Whichever treatment you use, it's very important to provide the correct dosing, which is usually determined by your child's weight or age. Also, ibuprofen should not be given to children who are 6 months or younger, are dehydrated or are vomiting, according to the American Academy of Pediatrics (AAP).

The AAP also says you shouldn't use either of these medications if your child is taking other medication for pain or fever, unless your doctor says this is OK. If your doctor does recommend using ibuprofen and acetaminophen together, it's important to keep careful track of how much of each medicine you've given your child. It may help to write down the time of each dose.

Aspirin has similar effects to acetaminophen and ibuprofen, but it should not be given to children because of a risk of a rare but serious illness called Reye Syndrome.

If your child has a fever and you're at all worried, be sure you talk to your doctor. It's particularly important to get medical advice if your child has a fever and:

• Is under 3 months old
• Has a seizure
• Has severe shivering
• Seems confused or doesn't respond to you easily
• Has signs of dehydration, such as urinating less than usual
• Is feeling more and more ill
• Has had a fever for longer than a few days.

—Sophie Ramsey, patient editor, BMJ Group

ConsumerReportsHealth.org has partnered with The BMJ Group to monitor the latest medical research and assess the evidence to help you decide which news you should use.

Read more on children's health and on vaccinations your children need before they head back to school.

Comments

[Anne]

must pay attentionn to your kids when a fever is happen..

[Peter Good]

One compelling reason to not give acetaminophen to infants and young children was reported in the May 2008 issue of the journal Autism. Schultz and coworkers found that children given acetaminophen for fever and pain after the measles-mumps-rubella (MMR) vaccination were significantly more likely to become autistic than children given ibuprofen. Schultz has also pointed out that the autism epidemic in California began not long after acetaminophen became the best selling over-the-counter painkiller in the U.S., and the public was first warned of the link between aspirin and Reye’s syndrome. The incidence of autism has risen ten-fold since the 1980s—the decade when acetaminophen largely replaced aspirin for infants and young children. Yet Orlowski and coworkers argued persuasively in 2002 that aspirin was not the cause of Reye’s syndrome. Surely this association between acetaminophen and autism warrants intensive investigation.

[Bill]

I have read lately that acetaminophen has been linked to allergies in children - might it be time to find a good alternative for reducing fever?