Antipyretic Efficacy of Acetaminophen and Ibuprofen in Critically Ill Pediatric Patients

被引:5
|
作者
Moffett, Brady S. [1 ,2 ]
Gutierrez, Kristina [2 ]
Davis, Kasey [2 ]
Sigdel, Binayak [2 ]
Strobel, Nathaniel [2 ]
机构
[1] Texas Childrens Hosp, Dept Pharm, Houston, TX 77030 USA
[2] Baylor Coll Med, Dept Pediat, Houston, TX 77030 USA
关键词
acetaminophen; enteral; fever; ibuprofen; intravenous; rectal; RECTAL PARACETAMOL; PHARMACOKINETICS; CHILDREN; TEMPERATURE; INFANTS; SAFETY; FEVER;
D O I
10.1097/PCC.0000000000002072
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objectives: To determine the antipyretic efficacy of acetaminophen (IV, enteral, rectal) and ibuprofen (enteral) in critically ill febrile pediatric patients. Design: Retrospective cohort study. Setting: Quaternary care pediatric hospital ICUs. Patients: Pediatric patients less than 19 years old who were febrile (>= 38.0 degrees C), received a dose of IV acetaminophen, enteral acetaminophen, rectal acetaminophen, or enteral ibuprofen and had at least one temperature measurement in the following 6 hours. Interventions: None. Measurements and Main Results: A total of 3,341 patients (55.8% male, median age 2.5 yr [interquartile range, 0.63-9.2 yr]) met study criteria. Baseline temperature was median 38.6 degrees C (interquartile range, 38.3-38.9 degrees C) measured via axillary (76.9%) route. Patients became afebrile (87.5%) at median 1.4 hours (interquartile range, 0.77-2.3 hr) after the first dose of medication, a -2.9 +/- 1.6% change in temperature. Antipyretic medications included as follows: enteral acetaminophen (n = 1,664), IV acetaminophen (n = 682), rectal acetaminophen (n = 637), and enteral ibuprofen (n = 358). Enteral ibuprofen had a significantly greater odds of defervescence on multivariable logistic regression analysis (p = 0.04) with a decrease of -1.97 +/- 0.89 degrees C while IV acetaminophen was significant for a decreased time to defervescence at median 1.5 hours (interquartile range 0.8-2.3 hr) after a dose (p = 0.03). Patient age, presence of obesity, and baseline temperature were significant for decreased antipyretic efficacy (p < 0.05). Conclusions: Enteral ibuprofen was the most efficacious antipyretic and IV acetaminophen had the shortest time to defervescence.
引用
收藏
页码:E386 / E393
页数:8
相关论文
共 50 条
  • [21] EVALUATION OF EFFICACY AND TOLERABILITY OF ACETAMINOPHEN (PARACETAMOL) AND MEFENAMIC ACID AS ANTIPYRETIC IN PEDIATRIC PATIENTS WITH FEBRILE ILLNESS: A COMPARATIVE STUDY
    Rahul, Kunkulol R.
    Aishwarya, Sonawane
    Chavva, Ashok Kumar
    INTERNATIONAL JOURNAL OF MEDICAL RESEARCH & HEALTH SCIENCES, 2013, 2 (01): : 23 - 29
  • [22] A Prospective Randomized Study to Evaluate the Antipyretic Effect of the Combination of Acetaminophen and Ibuprofen in Neurological ICU Patients
    Michael E. Mullins
    Matthew Empey
    David Jaramillo
    Sameta Sosa
    Theresa Human
    Michael N. Diringer
    Neurocritical Care, 2011, 15 : 375 - 378
  • [23] A Prospective Randomized Study to Evaluate the Antipyretic Effect of the Combination of Acetaminophen and Ibuprofen in Neurological ICU Patients
    Mullins, Michael E.
    Empey, Matthew
    Jaramillo, David
    Sosa, Sameta
    Human, Theresa
    Diringer, Michael N.
    NEUROCRITICAL CARE, 2011, 15 (03) : 375 - 378
  • [24] Dosing and Antipyretic Efficacy of Oral Acetaminophen in Children
    Temple, Anthony R.
    Temple, Brigham R.
    Kuffner, Edwin K.
    CLINICAL THERAPEUTICS, 2013, 35 (09) : 1361 - 1375
  • [25] ANTIPYRETIC EFFECT OF CENTRAL ALPHA-MSH SUMMATES WITH THAT OF ACETAMINOPHEN OR IBUPROFEN
    DEETER, LB
    MARTIN, LW
    LIPTON, JM
    BRAIN RESEARCH BULLETIN, 1989, 23 (06) : 573 - 575
  • [26] Antipyretic Therapy in Critically Ill Patients with Established Sepsis: A Trial Sequential Analysis
    Zhang, Zhongheng
    PLOS ONE, 2015, 10 (02):
  • [27] ACETAMINOPHEN AND OTHER ANTIPYRETIC ANALGESIC DRUGS - OPTIMAL DOSAGES IN PEDIATRIC-PATIENTS
    STAMM, D
    ARCHIVES DE PEDIATRIE, 1994, 1 (02): : 193 - 201
  • [28] Hemodynamic coherence in critically ill pediatric patients
    Erdem, O.
    Kuiper, J. W.
    Tibboel, D.
    BEST PRACTICE & RESEARCH-CLINICAL ANAESTHESIOLOGY, 2016, 30 (04) : 499 - 510
  • [29] GLYCEMIC PROFILE OF CRITICALLY ILL PEDIATRIC PATIENTS
    Rai, Rohit
    Goel, S. P.
    Prakash, Ashish
    Dubey, Archana
    Bansal, Kshitij
    JOURNAL OF EVOLUTION OF MEDICAL AND DENTAL SCIENCES-JEMDS, 2013, 2 (39): : 7548 - 7554
  • [30] TRANSPORT OF CRITICALLY ILL PEDIATRIC AND NEONATAL PATIENTS
    FANCONI, S
    DANGEL, P
    SCHWEIZERISCHE MEDIZINISCHE WOCHENSCHRIFT, 1990, 120 (06) : 174 - 177