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Fever Management

By John Hamerly, M.D.

 

Fever, an increase in body temperature, is one of the body's defenses against attack from infection or other disease. Fever is the most common of all pediatric complaints and affects adults as well.
 
Many factors influence body temperature including infections, vaccines, medications, injury, as well as, expected body temperature increases associated with exercise, excessive clothing, hot tub/bathing, or hot weather. Fever may actually be beneficial in the role of fighting infections and shortening their course by stimulating the body's immune system. It is believed that temperature increases the release and activity of white blood cells, as well as other immune complex aids.
 
Most fevers that children get in the 100 to 104 degree Fahrenheit range are not harmful. Many of these are caused by viruses and last during the duration of the illness, typically three to five days. In general, the height of the fever doesn't correlate to the correlate to the seriousness of the illness.
 
Treatment of fevers continually generates controversy among physicians and other health care providers. When we are sick it is difficult to remember that fever may actually help fight infection. As a general rule, treating fevers for symptom management may only be important if the temperature is in the moderate range, i.e. over 102 degrees Fahrenheit.
 
 As there is a risk of over treatment with medications, consider both medication and non-medication treatment strategies. Cool fluids, undressing a child, and allowing the body to be in a cooler environment is helpful. Keep hydrated with fluids and consider the following recommendations for medications:
 
Recommendations for Medications
 
Acetaminophen containing products (Tempra, Tylenol) can be given every four hours and is usually weight based as far as its dosing. A number of different formulations and strengths are available from drops up to pills.
 
Ibuprofen containing products (Advil, Motrin, others) are also weight-based and may have the advantage of being a little longer acting, being given every six hours.
 
Though aspirin is safe for adults, it is NOT recommended for the use of children because of the association of Reye's syndrome.
 
Within the last few years it has become popular to alternate ibuprofen and acetaminophen. The only advantage to this tactic is if the severity of the fever is not responsive to a single agent we do gain additional fever control by using two products. If you choose to use this strategy, consider the following: Give scheduled doses of both products (it is helpful to keep a chart as to the time and amount) by giving ibuprofen every six hours and Tylenol every four hours. At some of the dosing times both products will be given together, but due to the different time schedules there will be times where medications will be given at different times. In general staying with one product and scheduling its use regularly will often give adequate fever management.
 
Still confused about fevers—please feel free to ask any of the physicians at Family HealthServices Minnesota about fever or its management—starve a cold, feed a fever!
 
Fever Tips:
  • Drink cool fluids
  • Undress clothing
  • Find Cooler Environment
  • Medicine:
    No ASPIRIN for children (Reye's syndrome assoc.)

    Acetaminophen every four hours (weight-based dose)

    Ibuprofen every six hours (weight-based dose)
 
  • ALTERNATING: Gain additional fever control by using both ibuprofen and acetaminophen. Keep a chart with time and amount.
 

 

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