Comparison of acetaminophen and ketoprofen in febrile children: a single dose randomized clinical trial.

OBJECTIVE

To compare ketoprofen with acetaminophen in febrile children in terms of proportion of achieved temperatures below 37.8°C and time of temperature reduction.

METHODS

316 patients (6 months-12 years) with fever were randomly assigned to receive a single dose of acetaminophen or ketoprofen orally. Tympanic temperature was measured at the time of antipyretic administration and at 15, 30, 60, 120,180, 240 min thereafter.

RESULTS

A higher proportion of patients in the ketoprofen group achieved a temperature below 37.8°C during the 4 h follow up (95% CI, 3.03-12.99, p < 0.001). Treatment with ketoprofen was more likely to achieve temperature below 37.8°C compared to acetaminophen with odds ratio 6.25. (95% CI, 3.03-12.99, p < 0.001). Ketoprofen was superior at temperatures ≥39°C (p < 0.001). Ketoprofen group showed significantly lower mean temperatures at times 15 min (95% CI, 0.95-3.36; P < 0.001), 30 min (95% CI, 3.87-6.59; P < 0.001), 60 min (95% CI, 6.99-10.14; P < 0.001), 120 min (95% CI, 1.66-5.49; P < 0.001), 180 min (95% CI, 0.47-5.73; p < 0.05), and 240 min (95% CI, 3.87-6.59; p < 0.05). The mean temperature reductions at times 15, 30 and 60 min were larger in ketoprofen group (p < 0.001). Ketoprofen was superior to acetaminophen for less time with fever in the first 4 h (p < 0.001).

CONCLUSIONS

It seems reasonable to use ketoprofen first in need of rapid fever reduction.