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Introduction
Fever is one of the frequent reasons for admission to the emergency department. However, few studies have compared the efficacy of intravenous (IV) forms of ibuprofen and paracetamol in fever treatment in the emergency department.
Aim
The primary aim was to determine whether there was a difference in the in the rate of fever reduction between the drugs. The secondary aim was also to investigate whether there was a need for additional antipyretic treatment.
Patient Profile
- 200 patients with fever of >38°C by tympanic route (aged 18–65 years) and presented to the emergency department
- Method
Study Design
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- A prospective randomized double-blind study conducted in a tertiary university emergency department for a period of 6 months
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Patients were administered 400 mg of IV ibuprofen and 1000 mg of IV paracetamol via a 30-min infusion
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The patients were followed up for fever at 0, 15, 30, 45, and 60min
- Rescue therapy was applied when the 60th min temperature measurements of the patients were ≥38°C
Endpoints
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- A decrease in fever response of patients <38°C was considered as sufficient antipyretic efficiency
Results
Efficacy
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- Both ibuprofen and paracetamol significantly controlled fever in the first 30 min (p<0.001), with similar fever reduction efficiency (p=0.980) and the time to reach the desired fever response (p = 0.152)
- Ibuprofen and paracetamol were comparatively similar in terms of the need for rescue medication (p=0.404)
Figure 1: Comparison of the effect of IV forms of ibuprofen and paracetamol on febrile patients in ED
Safety
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- No side effects were observed in any of the patients
Conclusion
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- In patients with high fever admitted to the emergency department, 1000 mg IV paracetamol and 400mg of IV ibuprofen effectively and equally reduce fever. Both can be effectively used as each other's rescue medicine and as an alternative to each other in patients with comorbid diseases
- This was the first study comparing IV ibuprofen and IV paracetamol in the treatment of adult febrile patients admitted to emergency department
Am J Emerg Med 2021; 46: 102-106
