From the Guidelines
Fever should be managed with antipyretic therapy, such as acetaminophen or ibuprofen, to optimize patient comfort and reduce metabolic demand, especially in children with sepsis-associated organ dysfunction. The management of fever is a complex issue, and the approach may vary depending on the underlying cause and the patient's clinical condition 1. In general, fever is a temporary increase in body temperature, usually due to an infection, and is considered a temperature of 100.4°F (38°C) or higher in adults.
Key Considerations
- For children, fever can be a significant concern, especially in infants under 3 months, and should be evaluated by a doctor promptly 1.
- The use of antipyretic therapy, such as acetaminophen or ibuprofen, can help reduce fever and improve patient comfort 1.
- However, the decision to use antipyretic therapy should be individualized, taking into account the patient's underlying condition and the potential risks and benefits of treatment 1.
- In addition to antipyretic therapy, other measures such as staying hydrated, resting, and using lightweight clothing can help manage fever and improve patient comfort.
Special Considerations
- In children with sepsis-associated organ dysfunction, antipyretic therapy may be beneficial in reducing metabolic demand and improving patient comfort 1.
- However, the optimal approach to fever management in this population is not well established, and further research is needed to determine the best course of treatment 1.
- In general, fever itself is not an illness but rather the body's natural defense mechanism against infection, and treatment should focus on managing the underlying cause of the fever rather than just the symptom itself 1.
From the Research
Fever Management
- Neuroscience patients with fever may have worse outcomes than those who are afebrile 2
- There is no current evidence-based standard of care for fever management of the neurologically vulnerable patient 2
- Common interventions for fever and hyperthermia management include acetaminophen administration, ice packs, water cooling blankets, and tepid bathing 2
Role of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
- NSAIDs are commonly used for the management of fever, pain, and inflammation 3
- However, they have been considered to have a double-faced role, according to their capacity to manage inflammation but also their possible reduction of immune system response and diagnosis delay 3
- Ibuprofen, a type of NSAID, may be chosen considering the characteristics of the patient, the comorbidity, and the polytherapy 3
Management of Acute Upper Respiratory Tract Infection
- Upper respiratory tract infection (URTI) is an illness caused by an acute infection by viruses or bacteria of the nose, sinuses, pharynx, and larynx 4
- Early intervention, administered prior to the peaking of viral shedding, can reduce the chances of developing a full-blown acute URTI, decrease symptom severity, and reduce viral transmission 4
- Mucoadhesive gel nasal sprays have shown promising results for early intervention of acute URTI 4
Effect of NSAIDs on SARS-CoV-2 Infection
- NSAIDs, such as ibuprofen and meloxicam, can reduce production of pro-inflammatory cytokines and impair the humoral immune response to SARS-CoV-2 5
- However, NSAID treatment may not modify susceptibility to infection or viral replication 5
- The use of NSAIDs in COVID-19 patients has raised concerns, and further studies are needed to understand their effects on COVID-19 outcomes 6