Emergency Medical Minute22 Aug 2025

Episode 970: Fever Management

Contributor: Aaron Lessen, MD

Educational Pearls:

Recorded March 2025

What is the best treatment for a fever? Tylenol? Ibuprofen? Combined? Alternating the two?

The journal Pediatrics aimed to answer this question with a meta-analysis of 31 randomized controlled trials including 5,009 febrile children.
Results showed that both combined and alternating acetaminophen/ibuprofen regimens were significantly more effective at reducing fever at 4 and 6 hours compared with acetaminophen alone, with numbers needed to treat (NNT) of 3 and 4, respectively.
High-dose ibuprofen alone also offered modest benefit (NNT 8).

What dose should I use?

Oral acetaminophen
- 10 to 15 mg/kg
- Every 4–6 hours as needed
- Do not exceed 75 mg/kg/day (or 4,000 mg/day maximum for older/larger kids)
Oral ibuprofen
- 5 to 10 mg/kg
- Every 6–8 hours as needed
- Do not exceed 40 mg/kg/day (or 2,400 mg/day maximum for older/larger kids)

References

De la Cruz-Mena JE, Veroniki AA, Acosta-Reyes J, Estupiñán-Bohorquez A, Ibarra JA, Pana MC, Sierra JM, Florez ID. Short-term Dual Therapy or Mono Therapy With Acetaminophen and Ibuprofen for Fever: A Network Meta-Analysis. Pediatrics. 2024 Oct 1;154(4):e2023065390. doi: 10.1542/peds.2023-065390. PMID: 39318339.

Summarized by Jeffrey Olson, MS4 | Edited by Jeffrey Olson and Jorge Chalit, OMS4

Get your tickets to Tox Talks Event, Sept 11, 2025: https://emergencymedicalminute.org/events-2/

Donate: https://emergencymedicalminute.org/donate/

Det här avsnittet är hämtat från ett öppet RSS-flöde och publiceras inte av Podme. Det kan innehålla reklam.

Avsnitt(1166)

Podcast 1011: Creepy Crawlies

Contributor: Meghan Hurley, MD Educational Pearls: What animal is the most lethal to humans? Depending on how we define lethal, and animal, this answer is actually not straight forward. Globall...

6 Juli 7min

Podcast 1010: First Pass Intubation Success

Contributor: Travis Barlock, MD Educational Pearls: First-pass success is critical to limit complications from apnea, hypoxia, and airway trauma. Complication rate for patients intubated on the f...

29 Juni 3min

On the Streets- Zero to Rodeo

Dan Orbidan, OMS-II and Dr. Travis Barlock, MD discuss a real out of hospital call. This episode covers the implications of a pharmacologically abnormal patient presentation and the pre and post hospi...

22 Juni 35min

Carepoint Journal Club- Neurology

Carepoint Journal Club is a quarterly series with discussions about a medical topic, brought to you by Carepoint's Emergency Physicians.

15 Juni 36min

Podcast 1009: Prevention for Recurrent UTI

Contributor: Aaron Lessen, MD Educational Pearls: UTIs are commonly seen in older women We often see them taking long-term prophylactic antibiotics because of common recurrence. Around 20-30% of...

8 Juni 1min

Podcast 1008: Acupuncture for Low Back Pain in Older Adults

Contributor: Aaron Lessen, MD Educational Pearls: Back pain is a common presenting complaint in the emergency department. Challenges arise when tailoring care to elderly populations using standar...

1 Juni 2min

Podcast 1007: Caffeine Pharmacology

Contributor: Travis Barlock, MD Educational Pearls: Caffeine Geography and Types: Caffeine is found throughout the world and has evolved independently in various plants that are not evolutionarily...

25 Maj 4min

Podcast 1006: Cannabinoid Pharmacology

Contributor: Travis Barlock, MD Educational Pearls: Endocannabinoid System: THC binds CB1 and CB2 receptors in neurons and immune cells Δ9-Tetrahydrocannabinol (THC) is the main psychoactive compo...

18 Maj 5min