Choice of antipyretic in children.

The objective of this study was to evaluate the relative efficacy of 3 commonly used antipyretics viz. mefenamic acid, ibuprofen and paracetamol. The subjects were randomized to 3 groups to receive either paracetamol 10 mg/kg or ibuprofen 7 mg/kg or mefenamic acid 6.5 mg/kg. Axilla temperature was recorded just prior to drug administration and at hourly intervals for 4 hrs. The mefenamic acid group (n = 29) showed a drop of 3.5 degrees F at the end of 4 hours as compared to the paracetamol group (n = 29) (drop 2.44 degrees F) and ibuprofen group (n = 20) (drop 2.79 degrees F). Analysis of the area under the mean temperature vs. time curve showed that mefenamic acid demonstrated significantly better antipyretic activity compared to paracetamol (P < 0.05) over the entire period of observation and ibuprofen (P < 0.05) in the 2 to 4 hour range. Mefenamic acid continued to show antipyretic activity at the end of 4 hours in contrast to ibuprofen and paracetamol. Since the period of observation was restricted to 4 hours, we were unable to quantify the precise duration of its extended antipyretic efficacy.