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Treatment of fever in children
Last reviewed: 23.04.2024
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In most cases, fever acts as an adaptive response, which stimulates the immune response and increases resistance to infections.
Treatment of fever in children involves the appointment of antipyretic drugs, vasodilator drugs, the introduction of infusion therapy and oxygen therapy, the use of physical methods to enhance heat dissipation, according to indications, prescribe anticonvulsants.
Antipyretic drugs for fever
According to WHO recommendations, premorbid healthy children are not recommended to prescribe antipyretics if the body temperature does not exceed 38.0 ° C. Children with an anamnesis of febrile seizures, as well as neurological diseases, may be prescribed antipyretics at body temperature below 38.0 ° C.
When choosing antipyretic drugs, it is necessary to take into account its safety, possible methods of administration, the age of the child, the availability of children's dosage forms. Preparations of this group should be prescribed only when body temperature rises above the specified level, a regular "course" reception is not shown.
The main antipyretic drugs are paracetamol, ibuprofen, metamizole, acetylsalicylic acid.
- Paracetamol is the first choice drug for treating fever in children. He is considered the least dangerous. When expressed antipyretic and analgesic effects, it does not have a clinically significant anti-inflammatory property.
They release the drug in the form of tablets, syrup, drops and candles. A dosage form for parenteral administration has been developed. Its single dose is 10-15 mg / kg, it provides a decrease in body temperature by 1-1.5 ° C. The daily dose should not exceed 60 mg / kg due to the risk of liver damage.
The drug is well absorbed by their digestive tract. Simultaneous reception of antacid preparations reduces the rate of absorption of paracetamol. More than 90% of the dose taken is biotransformation in the liver. Metabolites, including active ones, are excreted by the kidneys.
Paracetamol is contraindicated in the case of the genetic absence of glucose-6-phosphate dehydrogenase. In newborns due to the peculiarities of drug elimination during repeated administration, its cumulation can occur.
- Ibuprofen is an antipyretics of the second row with individual intolerance or inefficiency of paracetamol.
The drug in liquid dosage forms is approved for use in children. It has a pronounced antipyretic, analgesic and anti-inflammatory properties, comparable in action to paracetamol. A single dose of the drug is 5-10 mg / kg, the daily dose should not exceed 20 mg / kg.
Of the side effects can occur skin reactions, dyspeptic disorders, gastrointestinal bleeding, there may be a decrease in renal blood flow up to the development of OPN.
- Metamizol sodium in children under 12 years can only be used as directed by a doctor. The drug has a pronounced analgesic and anti-inflammatory properties.
Metamizole sodium is released in the form of tablets and ampoule solutions, which makes it possible to use it parenterally.
A single dose of the drug is 3-5 mg / kg. It is rational to use it in children for relief of moderate postoperative pain. The introduction of metamizole sodium in fever can lead to a collapoid state due to a sharp drop in body temperature (below 36 ° C).
WHO does not recommend the use of metamizole sodium as an antipyretic, since even with a short reception it is able to cause agranulocytosis and aplastic anemia. The high risk of these serious complications was the reason for its prohibition in some countries.
- Acetylsalicylic acid has a pronounced antipyretic, anti-inflammatory and to a lesser extent analgesic effects. A single dose of the drug is 10-15 mg / kg. It can be used in children with rheumatic diseases.
Acetylsalicylic acid is contraindicated in children with ARVI up to 15 years, as it can cause Reye syndrome, the lethality at which reaches 50%.
If the drug is taken for a long time, there may be erosive and ulcerative gastrointestinal bleeding due to the systemic effect of the drug. In addition, it can provoke an attack of bronchial obstruction in children. In newborns, acetylsalicylic acid can displace bilirubin from its association with albumin, which contributes to the development of bilirubin encephalopathy.
[Vasodilator drugs
With the weak efficacy of antipyretics, an increase in heat transfer is indicated for the administration of vasodilator drugs. Given that with fever, the body loses a large amount of fluid, the introduction of vasodilator funds must be combined with adequate infusion therapy.
Physical Methods of Enhancing Heat Transfer
To enhance the heat transfer of the child wipe with cool water or liquids containing alcohol. In emergency situations, with increased body temperature above 41 ° C, a loss of consciousness or the development of seizures, you can apply more intensive physical methods of cooling. The child is placed in an ice bath or ice packs are applied to the head, neck, thighs, axillary cavities, and the stomach is washed with cold water.
Anticonvulsant therapy
Convulsive readiness is an indication for the administration of anticonvulsants.
Infusion therapy
Correction of water-electrolyte disorders and CBS are mandatory components of intensive treatment of fever in children of any etiology.