Abstract
BackgroundAntipyretic drugs are widely used in children with fever, though there is a controversy about the benefit of reducing fever in children with malaria. In order to assess the effect of ibuprofen on fever compared to placebo in children with uncomplicated Plasmodium falciparum malaria in Gabon, a randomized double blind placebo controlled trial, was designed.MethodsFifty children between two and seven years of age with uncomplicated malaria were included in the study. For the treatment of fever, all patients "received" mechanical treatment when the temperature rose above 37.5°C. In addition to the mechanical treatment, continuous fanning and cooling blanket, patients were assigned randomly to receive ibuprofen (7 mg/kg body weight, every eight hours) or placebo.ResultsThe fever clearance time using a fever threshold of 37.5°C was similar in children receiving ibuprofen compared to those receiving placebo. The difference was also not statistically significant using a fever threshold of 37.8°C or 38.0°C. However, the fever time and the area under the fever curve were significantly smaller in the ibuprofen group compared to the placebo group.ConclusionIbuprofen is effective in reducing the time with fever. The effect on fever clearance is less obvious and depends on definition of the fever threshold.Trial registrationThe trial registration number is: NCT00167713
Highlights
Antipyretic drugs are widely used in children with fever, though there is a controversy about the benefit of reducing fever in children with malaria
Antipyretic drugs are commonly and widely used to treat malarial fever in endemic areas, though there is a controversy about the benefit of reducing fever in children with malaria [4]
Data from Gabon have revealed that neither paracetamol, nor naproxen or metamizol – antipyretics often used in this area – had an effect on fever clearance time [5,6]
Summary
Antipyretic drugs are widely used in children with fever, though there is a controversy about the benefit of reducing fever in children with malaria. In order to assess the effect of ibuprofen on fever compared to placebo in children with uncomplicated Plasmodium falciparum malaria in Gabon, a randomized double blind placebo controlled trial, was designed. Antipyretic drugs are commonly and widely used to treat malarial fever in endemic areas, though there is a controversy about the benefit of reducing fever in children with malaria [4]. Data from Gabon have revealed that neither paracetamol, nor naproxen or metamizol – antipyretics often used in this area – had an effect on fever clearance time [5,6]. Paracetamol increased parasite-clearance times (i.e. inhibited clearance of parasites) and significantly decreased the production of oxygen radicals and tumor necrosis factor, mechanisms of the innate immune response pivotal to combat infections [5]
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