Alternating Ibuprofen and Acetaminophen in the Treatment of Febrile Hospitalized Children Aged 9-24 Months

Objective: Recently, studies reported the emergence and increasing popularity of the alternate use of acetaminophen and ibuprofen. The aim of the present study was to compare the clinical effectiveness of acetaminophen alone with an alternative regimen of acetaminophen and ibuprofen in hospitalized infants aged 9-24 months with fever of non bacterial origin.
Methods: The study was performed between March 2006 and December 2007, in pediatric center of two hospitals in Urmia. Patients were randomly separated into two groups. Eligible cases were febrile hospitalized patients aged between 9 and 24 months; whose rectal temperature was ≥38.5°C. Infants of case group received 10 mg/kg ibuprofen alternating with 15 mg/kg acetaminophen every four hours. Infants of control group received 15 mg/kg acetaminophen every four hours. Temperature of patients in the two groups was registered 2, 4, 5, 7, and 8 hours after drug administration. The study was completed when each group received 35 cases.
Findings: Seventy infants were divided into two groups. The case group consisted of 19 males and 16 females, in control group there were 18 males and 17 females. The results revealed significant difference between the two groups in lowering fever at 4, 5, 7 and 8 hours after treatment was initiated, but there was no significant difference at 2 hours after drug administration.
Conclusion: An alternating treatment of acetaminophen (15 mg/kg) and ibuprofen (10mg/kg) 4 hours later is more effective than acetaminophen in lowering fever in 9 to 24 month old infants.