Selections from Journal Watch Pediatrics and Adolescent Medicine Copyright © 2004 Massachusetts Medical Society. All rights reserved.

Acetaminophen vs. ibuprofen: which is better for kids? ▸

A frequently asked question in pediatric practices is: “What’s better for pain relief and fever, acetaminophen or ibuprofen?” Although most believe that they are comparable, their relative safety and efficacy in children are uncertain.

In this meta-analysis, researchers identified 17 blinded, randomized controlled trials published from 1985 through 2002 that compared single-dose acetaminophen and ibuprofen for pain and fever in children. Point estimates at 2 and 4 hours after treatment slightly (but not significantly) favored ibuprofen (4–10 mg/kg) compared with acetaminophen (7–15 mg/kg) for pain relief, but at 2, 4, and 6 hours, point estimates significantly favored ibuprofen for fever reduction. The relative superiority of ibuprofen for fever reduction doubled at higher therapeutic doses (10 mg/kg of ibuprofen vs. 10–15 mg/kg of acetaminophen). For example, 38% more children experienced fever reduction from ibuprofen than from acetaminophen 4 hours after treatment. No differences in safety were noted between the two drugs or between the two drugs and placebo.

Comment ▸

Ibuprofen is the better choice for treating fever in children, especially at higher therapeutic doses. For pain relief, ibuprofen and acetaminophen are comparable. These results cannot be generalized to multidose regimens.

Robert A. Dershewitz, MD, MSc

Published in Journal Watch June 22, 2004

Cleft lip and palate: increased mortality over time ▸

The short-term morbidity associated with cleft lip and palate has been well described, but little is known about the long-term health and survival of individuals with these congenital malformations. Using a Danish registry, these researchers assessed overall mortality and causes of …