Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children's Hospital, Seoul, Republic of Korea.
JMIR Mhealth Uhealth. 2021 May 26;9(5):e21668. doi: 10.2196/21668.
Fever is one of the most common symptoms in children and is the physiological response of the human immune system to external pathogens. However, effectiveness studies of single and combined antipyretic therapy are relatively few due to lack of data. In this study, we used large-scale patient-generated health data from mobile apps to compare antipyretic affects between single and combination antipyretics.
We aimed to establish combination patterns of antipyretics and compare antipyretic affects between single and combination antipyretics using large-scale patient-generated health data from mobile apps.
This study was conducted using medical records of feverish children from July 2015 to June 2017 using the Fever Coach mobile app. In total, 3,584,748 temperature records and 1,076,002 antipyretic records of 104,337 children were analyzed. Antipyretic efficacy was measured by the mean difference in the area under the temperature change curve from baseline for 6 hours, 8 hours, 10 hours, and 12 hours after antipyretic administration in children with a body temperature of ≥38.0 ℃ between single and combination groups.
The single antipyretic and combination groups comprised 152,017 and 54,842 cases, respectively. Acetaminophen was the most commonly used single agent (60,929/152,017, 40.08%), and acetaminophen plus dexibuprofen was the most common combination (28,065/54,842, 51.17%). We observed inappropriate use, including triple combination (1205/206,859, 0.58%) and use under 38 ℃ (11,361/206,859, 5.50%). Combination antipyretic use increased with temperature; 23.82% (33,379/140,160) of cases were given a combination treatment when 38 ℃ ≤ temperature < 39 ℃, while 41.40% (1517/3664) were given a combination treatment when 40 ℃ ≤ temperature. The absolute value of the area under the curve at each hour was significantly higher in the single group than in the combination group; this trend was consistently observed, regardless of the type of antipyretics. In particular, the delta fever during the first 6 hours between the two groups showed the highest difference. The combination showed the lowest delta fever among all cases.
Antipyretics combination patterns were analyzed using large-scale data. Approximately 75% of febrile cases used single antipyretics, mostly acetaminophen, but combination usage became more frequent as temperature increased. However, combination antipyretics did not show definite advantages over single antipyretics in defervescence, regardless of the combination. Single antipyretics are effective in reducing fever and relieving discomfort in febrile children.
发热是儿童最常见的症状之一，是人体免疫系统对外来病原体的生理反应。然而，由于缺乏数据，单一和联合解热治疗的有效性研究相对较少。在这项研究中，我们使用来自移动应用程序的大规模患者生成的健康数据来比较单一和联合解热剂的解热效果。
我们旨在建立解热剂的组合模式，并使用来自移动应用程序的大规模患者生成的健康数据来比较单一和联合解热剂的解热效果。
本研究使用 Fever Coach 移动应用程序于 2015 年 7 月至 2017 年 6 月期间记录的发热儿童的病历。共分析了 104337 名儿童的 3584748 个温度记录和 1076002 个解热记录，体温≥38.0℃的儿童在解热后 6 小时、8 小时、10 小时和 12 小时的体温变化曲线下面积的平均差异来衡量解热效果。
单药组和联合组分别包括 152017 例和 54842 例。对乙酰氨基酚是最常用的单一药物（60929/152017，40.08%），而对乙酰氨基酚加右旋布洛芬是最常见的联合药物（28065/54842，51.17%）。我们观察到了不适当的使用，包括三联（1205/206859，0.58%）和在 38℃以下使用（11361/206859，5.50%）。随着体温的升高，联合解热剂的使用增加；当 38℃≤体温<39℃时，23.82%（33，379/140160）的病例给予联合治疗，而当 40℃≤体温时，41.40%（1517/3664）的病例给予联合治疗。在每个小时的曲线下面积的绝对值在单药组中均显著高于联合组；这种趋势是一致的，无论使用何种解热剂。特别是，两组之间的第一个 6 小时的发热差值最高。在所有病例中，联合治疗的发热差值最低。
使用大规模数据对解热剂的联合模式进行了分析。约 75%的发热病例使用单一解热剂，主要是对乙酰氨基酚，但随着体温升高，联合使用的情况越来越多。然而，无论联合类型如何，联合解热剂在退热方面均未显示出明显优于单一解热剂的优势。单一解热剂在降低发热儿童的体温和缓解不适方面是有效的。
