Table 3 Antipyretics in febrile seizures

Citation Study group Study design (level of evidence) Outcome Key result Comments

Uhari et al (1995) 180 children after first febrile seizure randomised to 4 groups:
a) placebo + placebo
b) placebo + paracetamol
c) diazepam + paracetamol
d) diazepam + placebo
Randomised double blind placebo controlled trial (level 1b) Number of recurrence of FS a) 14 (25.4%)
b) 9 (16.4%)
c) 14 (25.5%)
d) 18 (32.7%)
(no statistical difference)
Duration of follow up: two years
Schnaiderman 
et al
(1993)
104 children after first febrile seizure randomised to two groups:
a) paracetamol 4-hourly
b) paracetamol as required
Randomised controlled trial (level 1b) Early recurrence of FS a) Regular paracetamol = 4 (7.5%)
b) PRN paracetamol = 5 (9.8%)
(p = not significant)
In hospital only (no follow up)
Van Stuijvenberg et al (1998) 230 children after first febrile seizure randomised to:
a) ibuprofen (n=111)
b) placebo (n=119)
Randomised double blind placebo controlled trial (level 1b) Number of recurrence of FS a) 31 (35.7%)
b) 36 (33%)
(p = not significant)
Mean duration of follow up 1.04 y
Von Esch et al (2000) Treatment group with:
a) ibuprofen or paracetamol (n=109)
b) no antipyretics (n=103)
Non-randomised controlled trial (level 2a) Number of recurrence of FS Recurrence risk per fever:
a) 6.3% (treatment group)
b) 12.2% (control group)
ARR = 5.9%; (95% CI: -0.2% to 12%)
 
Meremikwa et al (2002) RCTs with paracetamol compared to placebo Systematic review (level 1a) Number of recurrence of FS Conclusion: no evidence that paracetamol is effective in preventing FS