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Arch Dis Child 96:1175-1179 doi:10.1136/archdischild-2011-300424
  • Drug therapy

Systematic review of studies comparing combined treatment with paracetamol and ibuprofen, with either drug alone

Table 1

Study characteristics

Study Interventions Temperature Age Follow-up time
Lal et al9* G1: paracetamol 10 mg/kg 8 hourly, n=33 >38.5°C axilla Mean (95% CI) 2.85 years (1.75 to 3.95) and 3.02 (2.34 to 3.7) 5 days
G3: paracetamol 10 mg/kg and ibuprofen 10 mg/kg
8 hourly, n=18
Erlewyn-Lajeunesse et al14 G1: paracetamol 15 mg/kg single dose, n=37 ≥38°C tympanic 6 months–10 years 2 h
G2: ibuprofen 5 mg/kg single dose, n=35
G3: paracetamol 15 mg/kg and ibuprofen 5 mg/kg
single dose, n=36
Nabulsi et al13 G2: ibuprofen 10 mg/kg, followed by placebo at 4 h, n=33 ≥38.8°C rectal 6 months–14 years 8 h
G3: ibuprofen 10 mg/kg, followed by paracetamol
15 mg/kg at 4 h, n=36
Sarrell et al11 G1: paracetamol 12.5 mg/kg 6 hourly, n=154 ≥38.4°C rectal 6 months–3 years 10 days
G2: ibuprofen 5 mg/kg 8 hourly, n=155
G3: paracetamol 12.5 mg/kg alternately with ibuprofen
5 mg/kg 4 hourly, n=155
Hay et al10 G1: paracetamol 15 mg/kg 4–6 hourly, n=52 37.8–41°C axilla 6 months–6 years 5 days
G2: ibuprofen 10 mg/kg 6–8
hourly, n=52
G3: paracetamol 15 mg/kg 4–6 hourly
and ibuprofen 10 mg/kg
6–8 hourly, n=52
Kramer et al12 G1: paracetamol 15 mg/kg followed by placebo at 3 h
and paracetamol 15 mg/kg at 4 h, n=19
>38°C oral (rectal <2 years) 6 months–6 years 24 h
G3: paracetamol 15 mg/kg followed by ibuprofen
10 mg/kg at 3 h and
placebo at 4 h, n=19
Paul et al15 G1: ibuprofen 10 mg/kg followed by
paracetamol 15 mg/kg at 3 h, n=20
>38°C temporal artery 6 months–6 years 6 h
G2: ibuprofen 10 mg/kg
G3: ibuprofen 10 mg/kg and paracetamol 15 mg/kg
  • * This study also included a nimesulide arm not analysed here.

  • Half of each group were initially loaded with paracetamol and ibuprofen; because there was no difference these were analysed together.

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