Clinical Report-Fever and Antipyretic Use in Children
Clinical Report-Fever and Antipyretic Use in Children
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DOI：
10.1542/peds.2010-3852
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发表时间：
2011-03-01
期刊：
影响因子：
8
通讯作者：
Farrar, Henry C.
中科院分区：
文献类型：
--
作者：
Sullivan, Janice E.;Farrar, Henry C.
儿童发烧是儿科医生和其他卫生保健提供者管理的最常见的临床症状之一，也是父母关注的常见原因。许多父母甚至在发烧很轻微或没有发烧的情况下也会服用退烧药，因为他们担心孩子必须保持“正常”体温。然而，发热不是原发性疾病，而是一种生理机制，在对抗感染方面具有有益作用。没有证据表明发烧本身会影响疾病的进程，也没有证据表明发烧会导致长期的神经系统并发症。因此，治疗发热儿童的主要目标应该是改善儿童的整体舒适度，而不是专注于体温的正常化。当咨询发烧儿童的父母或照顾者时，应强调儿童的总体健康状况、监测活动的重要性、观察严重疾病的体征、鼓励适当的液体摄入以及安全储存退烧药。目前的证据表明，对乙酰氨基酚和布洛芬在治疗一般健康的发热儿童方面的安全性和有效性没有实质性差异。有证据表明，联合使用这两种产品比单独使用一种药物更有效;然而，人们担心联合治疗可能更复杂，并导致这些药物的不安全使用。儿科医生还应该通过提倡简化配方、给药说明和给药装置来促进患者安全。儿科2011;127：580-587
Fever in a child is one of the most common clinical symptoms managed by pediatricians and other health care providers and a frequent cause of parental concern. Many parents administer antipyretics even when there is minimal or no fever, because they are concerned that the child must maintain a "normal" temperature. Fever, however, is not the primary illness but is a physiologic mechanism that has beneficial effects in fighting infection. There is no evidence that fever itself worsens the course of an illness or that it causes long-term neurologic complications. Thus, the primary goal of treating the febrile child should be to improve the child's overall comfort rather than focus on the normalization of body temperature. When counseling the parents or caregivers of a febrile child, the general well-being of the child, the importance of monitoring activity, observing for signs of serious illness, encouraging appropriate fluid intake, and the safe storage of antipyretics should be emphasized. Current evidence suggests that there is no substantial difference in the safety and effectiveness of acetaminophen and ibuprofen in the care of a generally healthy child with fever. There is evidence that combining these 2 products is more effective than the use of a single agent alone; however, there are concerns that combined treatment may be more complicated and contribute to the unsafe use of these drugs. Pediatricians should also promote patient safety by advocating for simplified formulations, dosing instructions, and dosing devices. Pediatrics 2011;127:580-587