Therapy of fever in children with acute respiratory diseases

January 23, 2018

In the complex treatment of acute respiratory infections in children most recommendations include non-steroidal anti-inflammatory drugs, including ibuprofen and acetaminophen for use with an antipyretic purpose in pediatrics. The data of literature and own experience of application of ibuprofen in children with acute respiratory infections associated with fever and intoxication syndrome are shown. It has been found that ibuprofen is an effective first-line drug for the relief of fever in children, especially when combined with pain and severe intoxication syndromes, and has a high safety profile in children.

Yu.V. Marushko, T.V. Hyshchak

Key words: fever, acetaminophen, ibuprofen.

Published: 06.03.2018


  • DP «Derzhavnyi ekspertnyi tsentr MOZ Ukrainy» (2016) Osnovni pokaznyky roboty systemy farmakonahliadu Ukrainy za 2016 rik (
  • Marushko Yu.V., Boiko N.S. (2014) Dosvid zastosuvannia preparatu Nurofien® dlia ditei u pediatrychnii praktytsi. Ukr. med. chasopys, 2(100): 83–85 (
  • Marushko Yu.V., Hyshchak T.V., Myka M.Iu., Todyka Yu.I. (2016) Dosvid vykorystannia preparatu Nurofien® dlia ditei Forte v pediatrychnii praktytsi. Zdorove rebenka, 5(73): 33–38.
  • Marushko Yu.V., Nahorna T.I. (2013) Hipertermiia ta zastosuvannia antypiretykiv u pediatrychnii praktytsi. Ukr. med. chasopys, 4(96): 45–48 (
  • Marushko Yu.V., Todыka Yu.Y., Harbar Y.Y. (2013) Dokazatelnaia baza эffektyvnosty y bezopasnosty prymenenyia ybuprofena v pedyatryy. Ukr. med. chasopys, 5(97): 77–80 (
  • MOZ Ukrainy (2014) Nakaz MOZ Ukrainy vid 16.07.2014 r. № 499 «Pro zatverdzhennia ta vprovadzhennia medyko-tekhnolohichnykh dokumentiv zi standartyzatsii medychnoi dopomohy pry hrypi ta hostrykh respiratornykh infektsiiakh» (
  • Alvar J., Vélez I.D., Bern C. et al.; WHO Leishmaniasis Control Team (2012) Leishmaniasis worldwide and global estimates of its incidence. PLoS One, 7(5): e35671.
  • Barbi E., Marzuillo P., Neri E. et al. (2017) Fever in Children: Pearls and Pitfalls. Children (Basel), 4(9): E81.
  • Chandrakasan S., Filipovich A.H. (2013) Hemophagocytic lymphohistiocytosis: advances in pathophysiology, diagnosis, and treatment. J. Pediatr., 163(5): 1253–1259.
  • Chow A., Robinson J.L. (2011) Fever of unknown origin in children: a systematic review. World J. Pediatr., 7(1): 5–10.
  • de Bont E.G., Lepot J.M., Hendrix D.A. et al. (2015) Workload and management of childhood fever at general practice out-of-hours care: an observational cohort study. BMJ Open, 5(5): e007365.
  • de Martino M., Chiarugi A. (2015) Recent Advances in Pediatric Use of Oral Paracetamol in Fever and Pain Management. Pain Ther., 4(2): 149–168.
  • Flaherty E.G., MacMillan H.L. (2013) Caregiver-Fabricated Illness in a Child: A Manifestation of Child Maltreatment. Pediatrics, 132: 590–597.
  • Harden L.M., Kent S., Pittman Q.J., Roth J. (2015) Fever and sickness behavior: Friend or foe? Brain Behav. Immun., 50: 322–333.
  • Kim S.Y., Chang Y.J., Cho H.M. et al. (2013) Non-steroidal anti-inflammatory drugs for the common cold. Cochrane Database Syst. Rev., 6: CD006362.
  • Marzuillo P., Guarino S., Barbi E. (2014) Paracetamol: A focus for the general pediatrician. Eur. J. Pediatr., 173: 415–425.
  • National Collaborating Centre for Women’s and Children’s Health (2013) National Collaborating Centre for Women’s and Children’s Health. Feverish Illness in Children: Assessment and Initial Management in Children Younger than 5 Years. London, UK.
  • National Institute for Health and Care Excellence (2013) Fever in under 5s: assessment and initial management. Clinical guideline (
  • Rajanayagam J., Bishop J.R., Lewindon P.J., Evans H.M. (2015) Paracetamol-associated acute liver failure in Australian and New Zealand children: High rate of medication errors. Arch. Dis. Child., 100: 77–80.
  • Richardson M., Purssell E. (2015) Who’s afraid of fever? Arch. Dis. Child., 100: 818–820.
  • Rigante D., Rossodivita A., Cantarini L. (2014) Unmasking an obstinate fever. Isr. Med. Assoc. J., 16: 326–328.
  • Sands R., Shanmugavadivel D., Stephenson T., Wood D. (2012) Medical problems presenting to paediatric emergency departments: 10 years on. Emerg. Med. J., 29: 379–382.
  • Sullivan J.E., Farrar H.C. (2011) Clinical report — Fever and Antipyretic Use in Children. Pediatrics, 127(3): 580–587.
  • Sullivan J.E., Farrar H.C., American Academy of Pediatrics Section on Clinical Pharmacology and Therapeutics. Committee on Drugs (2011) Fever and antipyretic use in children. Pediatrics, 127: 580–587.
  • Trautner B.W., Caviness A.C., Gerlacher G.R. (2006) Prospective evaluation of the risk of serious bacterial infection in children who present to the emergency department with hyperpyrexia (temperature of 106 degrees F or higher). Pediatrics, 118: 34–40.
  • van den Anker J.N. (2013) Optimising the management of fever and pain in children. Int. J. Clin. Pract., 67 (Suppl. 178): 26–32.
  • Whitburn S., Costelloe C., Montgomery A.A. et al. (2011) The frequency distribution of presenting symptoms in children aged six months to six years to primary care. Prim. Health Care Res., 12: 123–134.
  • WHO (2015) 5th WHO Model List of Essential Medicines for Children (
  • Wong T., Stang A.S., Ganshorn H. et al. (2014) Combined and alternating paracetamol and ibuprofen therapy for febrile children. Based Child Heal. A Cochrane Rev. J., 9: 675–729.
  • Yue Z., Jiang P., Sun H., Wu J. (2014) Association between an excess risk of acute kidney injury and concomitant use of ibuprofen and acetaminophen in children, retrospective analysis of a spontaneous reporting system. Eur. J. Clin. Pharmacol., 70: 479–482.