de Bont Eefje G P M, Brand Paul L P, Dinant Geert-Jan, van Well Gijs T J, Cals Jochen W L
Universiteit Maastricht, vakgroep Huisartsgeneeskunde en School for Public Health and Primary Care, Maastricht.
Ned Tijdschr Geneeskd. 2014;158(2):A6636.
Worldwide, paracetamol is the most commonly used antipyretic for children and the drug of first choice for reducing fever named in the majority of practice guidelines. However, whether or not it is necessary or desirable to treat fever is questionable. The provision of accurate information on the causes and treatment of fever can decrease the help-seeking behaviour of parents. Paracetamol is both effective and advisable when there is a combination of fever and pain. Fever on its own does not require treatment and doctors should therefore show caution about advising paracetamol for children who have just this symptom. The effect of paracetamol on the general well-being of children with fever on its own has not been unequivocally proven. Treatment with paracetamol for the prevention of febrile convulsions has been proven ineffective. There are indications that inhibiting fever through paracetamol can adversely affect the immune response. The use of paracetamol can produce mild side effects and hepatotoxicity.
在全球范围内,对乙酰氨基酚是儿童最常用的退烧药,也是大多数实践指南中推荐的首选退烧药物。然而,是否有必要或是否应该治疗发烧是值得怀疑的。提供关于发烧原因和治疗的准确信息可以减少家长寻求帮助的行为。当发烧与疼痛同时出现时,对乙酰氨基酚既有效又可取。单纯发烧本身不需要治疗,因此医生在为仅有这种症状的儿童建议使用对乙酰氨基酚时应谨慎。对乙酰氨基酚对单纯发烧儿童总体健康状况的影响尚未得到明确证实。用对乙酰氨基酚预防热性惊厥已被证明无效。有迹象表明,通过对乙酰氨基酚抑制发烧可能会对免疫反应产生不利影响。使用对乙酰氨基酚可能会产生轻微副作用和肝毒性。