Safe antipyretic therapy

The publication presents current information on pyretic situations in pediatric practice. Along with known data, attention is drawn to terminological features and the need for a differentiated approach to conditions accompanied by an increase in body temperature, and pathogenetic and clinical aspects of both hyperthermia and fever are considered. The terms hyperthermia, pyrexia, pyrogenic fever, which are not synonyms, are described in detail. High body temperature can be caused by fever or hyperthermia. The differences between these definitions are obvious and fundamental, since they have different causes, clinical manifestations, and therapeutic strategies. The work identifies indications for antipyretic therapy with an emphasis on the mechanisms of action of recommended drugs, presents the main characteristics and distinctive features of the main antipyretic drugs. An important section of the article is devoted to the analysis of priority randomized placebo-controlled studies on the comparative evaluation of the effectiveness of various approaches to the treatment of fever with monotherapy with paracetamol or ibuprofen, as well as the alternate or combined use of these drugs. The data of a number of studies, which show some differences in the clinical effect, support the expediency of using the two drugs simultaneously. It has been shown that paracetamol has a faster antipyretic effect, while ibuprofen has a longer-lasting effect. The results of the review are of scientific interest, deserve the attention of practicing doctors, confirm the importance of the problem of antipyretic therapy in childhood based on a personalized approach. The article draws attention to the fact that paracetamol and ibuprofen recommended for use as antipyretic agents and are officially recommended by the World Health Organization, clinical and national programs for use in pediatrics as antipyretic agents.