| Title | Antipyretic agents for preventing recurrences of febrile seizures: randomized controlled trial. | | Author(s) | Strengell T, Uhari M, Tarkka R, Uusimaa J, Alen R, Lautala P, Rantala H | | Institution | Department of Pediatrics, University of Oulu, Oulu, Finland. | | Source | Arch Pediatr Adolesc Med 2009 Sep; 163(9):799-804. | | MeSH | Acetaminophen
Administration, Oral
Analysis of Variance
Anti-Inflammatory Agents, Non-Steroidal
Chi-Square Distribution
Child, Preschool
Diclofenac
Double-Blind Method
Drug Therapy, Combination
Female
Humans
Ibuprofen
Infant
Male
Placebos
Recurrence
Seizures, Febrile
Suppositories
Time Factors
Treatment Outcome
| | Abstract | OBJECTIVE: To evaluate the efficacy of different antipyretic agents and their highest recommended doses for preventing febrile seizures.
DESIGN: Randomized, placebo-controlled, double-blind trial.
SETTING: Five hospitals, each working as the only pediatric hospital in its region.
PARTICIPANTS: A total of 231 children who experienced their first febrile seizure between January 1, 1997, and December 31, 2003. The children were observed for 2 years.
INTERVENTIONS: All febrile episodes during follow-up were treated first with either rectal diclofenac or placebo. After 8 hours, treatment was continued with oral ibuprofen, acetaminophen, or placebo.
MAIN OUTCOME MEASURE: Recurrence of febrile seizures.
RESULTS: The children experienced 851 febrile episodes, and 89 of these included a febrile seizure. Febrile seizure recurrences occurred in 54 of the 231 children (23.4%). There were no significant differences between the groups in the main measure of effect, and the effect estimates were similar, as the rate was 23.4% (46 of 197) in those receiving antipyretic agents and 23.5% (8 of 34) in those receiving placebo (difference, 0.2; 95% confidence interval, -12.8 to 17.6; P = .99). Fever was significantly higher during the episodes with seizure than in those without seizure (39.7 degrees C vs 38.9 degrees C; difference, 0.7 degrees C; 95% confidence interval, -0.9 degrees C to -0.6 degrees C; P < .001), and this phenomenon was independent of the medication given.
CONCLUSIONS: Antipyretic agents are ineffective for the prevention of recurrences of febrile seizures and for the lowering of body temperature in patients with a febrile episode that leads to a recurrent febrile seizure. | | Language | eng | | Pub Type(s) | Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
| | PubMed ID | 19736332 |
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