Ibuprofen vs. paracetamol for typhoid fever

Ibuprofen has proved its worth as adjunctive treatment in children with typhoid fever, according to a team of tropical disease specialists in London, Oxford and Vietnam ( Ped Inf Dis J 2004;23:226-30 ).

Eighty children with uncomplicated fever were randomised to treatment with ibuprofen syrup 10 mg/kg or paracetamol syrup 12 mg/kg every 6 hours, until 36 hours after their fever had subsided. In children treated with ibuprofen, the median time to fever clearance was substantially and significantly lower than with paracetamol (68 vs. 105 hours), though the range of clearance times was large in both cases (4 – 260 hours with ibuprofen and 12 to 404 hours with paracetamol). There was a similar difference in the area under the temperature-time curve >37°C (74 vs. 127).

Salmonella typhi was isolated from 90 percent of children. The differences between ibuprofen and paracetamol were found to occur largely in 24 children infected with a strain resistant to nalidixic acid, who responded more slowly to antibiotic therapy and had a more prolonged fever. Both antipyretics were well tolerated.

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