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Fever and

Antipyretic Usein Children

Janice E. Sullivan, M.D.Professor of PediatricsUniversity of Louisville

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Prepared for your next patient.

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Statements and opinions expressed are those of the authorsand not necessarily those of the American Academy ofPediatrics.

Mead Johnson sponsors programs such as this to give

healthcare professionals access to scientic and educationalinformation provided by experts. The presenter has completeand independent control over the planning and content of the

presentation, and is not receiving any compensation from MeadJohnson for this presentation. The presenters comments and

opinions are not necessarily those of Mead Johnson. "n theevent that the presentation contains statements about uses of

drugs that are not #ithin the drugs$ approved indications, MeadJohnson does not promote the use of any drug for indicationsoutside the %&A'approved product label.

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OVERVIEW

%ever

Antipyresis

Therapeutic goals

Safety Summary

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FEVER

(ne of most common clinical symptoms managedby pediatricians and other )*Ps

o +nscheduled physician visits

oTelephone calls

*auses heightened anxiety in parents andcaregivers

Pediatricians and nurses are the primary resourcefor information on fever management for parents

and caregivers

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FEVER

%ever rectal temperature - /.0 * 12020 %3o "nfants 4 months of age /0* 1200.50 %3

6ormal physiologic response

o 7esults in an increase in the hypothalamic 8setpoint9

7esponse to endogenous and exogenous pyrogens

Most fevers are of short duration and are benign

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FEVER

:enets of fevero Protective role in the immune system

"nhibition of gro#th and replication of microorganisms

Aids in bodys acute phase reaction

;nhanced immunologic function of #bcs lymphocyte response to mitogens

bactericidal activity of neutrophils

production of interferon

Promotion of monocyte maturation into macrophages

Promotion of lymphocyte activation and antibodyproduction

&ecreased availability of free iron for bacterialreplication

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FEVER AND ILLNESS

Antipyretics may prolong course of illnesso Adults #ith rhinovirus shed the virus longer

o *hildren #ith varicella have delayed time forlesions to crust 1about 2 day3

o *hildren #ith malaria ta vs >? hours3

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FEVER !O"IA#

Term coined in early 2?/0s by :& Schmitt, M.&. Primary fears

o :rain damage

o *oma

o Sei@ures

o :lindness

o &eath

(ther contributorsoTechnology

o Pharmaceuticals

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AN$I%RESIS

Many parents aim for 8normal9 temperatureo &aycare, school #or< can drive this

Antipyresis therapy &(;S 6(T

o 7educe morbidity or mortality from a febrileillness

o &ecrease the recurrence of febrile sei@ures

Antipyresis &(;S

o

7elieve discomforto &ecrease insensible Buid loss

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AR&U'EN$S A&AINS$ AN$I%RESIS

%ever is not an illness Most fevers are short'lived and benign

%ever may protect the host

&egree of fever does not correlate #ith severityof illness

fever may obscure diagnostic or prognosticsigns

6o evidence that children #ith fever are at ris