Paul Ian M, Walson Philip D
Pediatrics and Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
Department of Clinical Pharmacology, University Medical Center at Georg-August-Universität, Göttingen, Germany.
Curr Med Res Opin. 2021 Aug;37(8):1363-1375. doi: 10.1080/03007995.2021.1928617. Epub 2021 Jun 4.
A narrative review of randomized, blinded, controlled studies assessing the antipyretic effect of ibuprofen versus acetaminophen or combined or alternating treatment in children was conducted.
Searches of the PubMed and Embase literature databases were conducted to identify relevant articles. Selected articles were limited to studies published in English that investigated OTC oral tablet and syrup formulations of acetaminophen and ibuprofen; there were no publication date limits. Open-label studies, nonrandomized studies, and those evaluating intravenous or suppository formulations of acetaminophen or ibuprofen were excluded. Variations in designs, endpoints, methods, and patient populations precluded our ability to conduct a formal systematic review.
At physician-directed dosing (acetaminophen 15 mg/kg vs ibuprofen 10 mg/kg), no significant differences in antipyretic effects from 0‒6 h and between 0‒6, ‒12, ‒24, or ‒48 h, with single or multiple-doses, respectively, were observed. Tolerability profiles at physician dosing were similar. In 14 over-the-counter dose comparisons (acetaminophen, 10-15 mg/kg; ibuprofen, 2.5-10 mg/kg), antipyresis favored ibuprofen in 6, was similar between groups in 7, and favored acetaminophen (15 mg/kg vs ibuprofen 5 mg/kg) in 1 comparison. Both medications were well tolerated. Efficacy favored combination over individual components in 3 of 4 studies; alternating use results were mixed. All combination or alternating treatments were well tolerated.
Antipyretic effects of ibuprofen and acetaminophen are similar at physician-directed doses; ibuprofen may be modestly superior at over-the-counter doses.
对评估布洛芬与对乙酰氨基酚在儿童中的退热效果以及联合或交替治疗的随机、双盲、对照研究进行叙述性综述。
检索PubMed和Embase文献数据库以识别相关文章。所选文章限于以英文发表的研究，这些研究调查了对乙酰氨基酚和布洛芬的非处方口服片剂和糖浆制剂；无出版日期限制。排除开放标签研究、非随机研究以及评估对乙酰氨基酚或布洛芬静脉或栓剂制剂的研究。设计、终点、方法和患者人群的差异使我们无法进行正式的系统评价。
在医生指导剂量下（对乙酰氨基酚15mg/kg对比布洛芬10mg/kg），分别观察单剂量或多剂量时，0至6小时以及0至6、-12、-24或-48小时之间的退热效果无显著差异。医生给药时的耐受性概况相似。在14次非处方剂量比较中（对乙酰氨基酚10 - 15mg/kg；布洛芬2.5 - 10mg/kg），6次中布洛芬退热效果更佳，7次中两组相似，1次比较中对乙酰氨基酚（15mg/kg对比布洛芬5mg/kg）退热效果更佳。两种药物耐受性均良好。4项研究中有3项显示联合用药疗效优于单一成分；交替使用的结果不一。所有联合或交替治疗耐受性均良好。
在医生指导剂量下，布洛芬和对乙酰氨基酚的退热效果相似；在非处方剂量下布洛芬可能略优。
