Matsiégui Pierre-Blaise, Missinou Michel A, Necek Magdalena, Mavoungou Elie, Issifou Saadou, Lell Bertrand, Kremsner Peter G
Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon.
Malar J. 2008 May 26;7:91. doi: 10.1186/1475-2875-7-91.
Antipyretic drugs are widely used in children with fever, though there is a controversy about the benefit of reducing fever in children with malaria. In order to assess the effect of ibuprofen on fever compared to placebo in children with uncomplicated Plasmodium falciparum malaria in Gabon, a randomized double blind placebo controlled trial, was designed.
Fifty children between two and seven years of age with uncomplicated malaria were included in the study. For the treatment of fever, all patients "received" mechanical treatment when the temperature rose above 37.5 degrees C. In addition to the mechanical treatment, continuous fanning and cooling blanket, patients were assigned randomly to receive ibuprofen (7 mg/kg body weight, every eight hours) or placebo.
The fever clearance time using a fever threshold of 37.5 degrees C was similar in children receiving ibuprofen compared to those receiving placebo. The difference was also not statistically significant using a fever threshold of 37.8 degrees C or 38.0 degrees C. However, the fever time and the area under the fever curve were significantly smaller in the ibuprofen group compared to the placebo group.
Ibuprofen is effective in reducing the time with fever. The effect on fever clearance is less obvious and depends on definition of the fever threshold.
The trial registration number is: NCT00167713.
退烧药广泛应用于发热儿童,尽管对于降低疟疾患儿体温的益处存在争议。为了评估在加蓬患有单纯性恶性疟原虫疟疾的儿童中,布洛芬与安慰剂相比对发热的影响,设计了一项随机双盲安慰剂对照试验。
50名2至7岁患有单纯性疟疾的儿童纳入研究。对于发热治疗,所有患者体温升至37.5摄氏度以上时“接受”物理治疗。除物理治疗(持续扇风和使用降温毯)外,患者被随机分配接受布洛芬(7毫克/千克体重,每8小时一次)或安慰剂。
与接受安慰剂的儿童相比,接受布洛芬治疗的儿童以37.5摄氏度为发热阈值时的退热时间相似。以37.8摄氏度或38.0摄氏度为发热阈值时,差异也无统计学意义。然而,布洛芬组的发热时间和发热曲线下面积明显小于安慰剂组。
布洛芬可有效缩短发热时间。对退热的效果不太明显,且取决于发热阈值的定义。
试验注册号为:NCT00167713。