What is the treatment for pyrexia (fever)?

From the Guidelines

Fever should not be treated with antipyretics as the sole aim of reducing body temperature, but instead, patients should be advised to take paracetamol if they have fever and other symptoms that antipyretics would help treat, as recommended by the most recent guidelines 1. The treatment of pyrexia (fever) has evolved, and the current approach prioritizes managing symptoms rather than solely focusing on reducing body temperature.

Key Considerations

• The use of antipyretics should be based on the presence of other symptoms that these medications can help alleviate, rather than just reducing fever 1.
• Patients should be advised to drink fluids regularly to avoid dehydration, with a recommended intake of no more than 2 liters per day 1.
• Paracetamol is preferred over non-steroidal anti-inflammatory drugs (NSAIDs) for patients with COVID-19, until more evidence becomes available 1.

Treatment Approach

• Paracetamol should be taken only while the symptoms of fever and other symptoms are present, as this approach helps manage discomfort without unnecessarily reducing body temperature 1.
• The dose and frequency of paracetamol should be as directed by the packaging or medical professional, typically 325-650 mg every 4-6 hours for adults.
• It is essential to stay hydrated by drinking plenty of fluids, as fever can cause fluid loss through sweating.
• Rest is crucial to help the body fight the underlying cause of fever.
• Applying cool compresses or taking a lukewarm bath can help lower body temperature, and dressing in light clothing and keeping the room temperature comfortable can also aid in managing fever.

When to Seek Medical Attention

• Fever exceeding 103°F (39.4°C)
• Fever lasting more than three days
• Fever accompanied by severe headache, stiff neck, confusion, difficulty breathing, or rash It is crucial to follow these guidelines and consult medical professionals for personalized advice, especially in cases where the patient's condition worsens or does not improve with the recommended treatment, as suggested by recent studies 1.

From the FDA Drug Label

Stop use and ask doctor if ... fever gets worse or lasts more than 3 days PURPOSE Pain reliever/fever reducer The treatment for pyrexia (fever) is acetaminophen (PO), which is a pain reliever/fever reducer 2 2.

• It is used to reduce fever.
• If fever gets worse or lasts more than 3 days, stop use and ask a doctor.

From the Research

Treatment Options for Pyrexia (Fever)

• The treatment for pyrexia (fever) includes the use of antipyretics, such as paracetamol and ibuprofen, to reduce body temperature 3, 4, 5, 6, 7.
• Paracetamol is a commonly used antipyretic that works by inhibiting cyclooxygenase-3 and prostaglandin synthesis in the central nervous system, resetting the hypothalamic heat-regulation center 3.
• Ibuprofen is also an effective antipyretic, and its use alone or in combination with paracetamol has been studied in various trials 4, 5, 7.
• Combined therapy with paracetamol and ibuprofen may result in a lower mean temperature at one hour after treatment and fewer children remaining or becoming febrile for at least four hours after treatment, compared to monotherapy alone 5, 7.
• Alternating therapy with paracetamol and ibuprofen may also be effective in reducing temperatures and improving child discomfort, although the evidence for this is less conclusive 5, 7.

Considerations for Treatment

• Fever is not always harmful and may actually benefit the host defense mechanism, so routine antipyretic therapy should be avoided unless necessary 6.
• Antipyretic agents can have significant side effects, and their use should be carefully considered in individual patients, especially those with underlying cardiovascular or neurologic disorders 6.
• The choice of treatment regimen, including combined or alternating therapy, should be based on the individual patient's needs and medical history, as well as the potential benefits and risks of each treatment option 3, 4, 5, 6, 7.