Complementary, Holistic, and Integrative Medicine: Fever

Abstract

1. Derek Wang* 2. Cecilia Bukutu, PhD* 3. Alison Thompson, BN, MN* 4. Sunita Vohra, MD, FRCPC, MSc* 1. *Complementary and Alternative Research and Education (CARE) Program, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada. On behalf of the American Academy of Pediatrics Section on Complementary and Integrative Medicine Fever, commonly defined as a temperature of 99.5°F (37.5°C) or greater (axillary) or 100.4°F (38.0°C) or greater (core), is a common pediatric sign that has many causes (eg, bacterial or viral infection). Some of the causes are self-limiting and do not require treatment; others are serious underlying conditions requiring treatment. In children (particularly infants), seeking medical attention for the evaluation, diagnosis, and treatment of the underlying cause of fever is standard care. (1) Some families seek to alleviate fever and its associated symptoms (eg, discomfort, irritability, crying) through easily accessible, adjunctive self-care techniques and complementary and alternative medicine (CAM) therapies. This review discusses common CAM therapies that have been used to treat fever in children and is limited to the following modalities, for which published scientific literature is available: physical methods, natural health products (NHPs), and traditional Chinese medicine (TCM). Physical methods such as tepid sponging, bathing, fanning, and cooling blankets often are used to treat fever. (2)(3) Although physical methods often are inexpensive and readily available, the efficacy of many of these methods has not been established through rigorous research. (4) A 2006 systematic review of seven quasi-randomized, controlled trials (RCTs) that included children (n=467) ages 1 month to 15 years who had fever of a “presumed infectious origin” compared physical methods (eg, tepid sponging) with or without a drug treatment (antipyretic) to a drug treatment, placebo, or no treatment. (4) Of the seven studies, three small trials had positive findings and demonstrated that tepid sponging helped to reduce fever in children. However, these findings were observed in children who had already taken acetaminophen, so it is unclear whether the tepid sponging was responsible for the observed reduction in fever. The trials considered in this systematic review had very small numbers and suffered from various methodologic …