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It is impossible to disagree with the results of this study. However,
in practice I think the use of both drugs separately every few hours is
very useful in treating childhood pyrexia where the temperature is rising
again before it is considered safe to administer a second dose of either
drug. Alternating them allows more frequent safe anti-pyretic effects.
The study conducted by Erlewy-Lajeunesse et al. is welcomed and
addresses the validity of a radicated clinical practice unsupported by
In the discussion the authors clearly state that the study only
examined the short term (at one hour) impact of the combined therapy and
that longer measurement periods might present different results.
However, the authors' final stat...
However, the authors' final statement that the measured effect does
not "warrant routine use for rapid fever reduction" goes beyond the
findings of the study.
Further studies are needed to ascertain the impact of the combined
therapy on long term impact (> 4 hours) measuring not only the drop in
temperature but also estimating the number of repeat doses required to
control the pyrexia under each intervention.
It should also be noted that 15 mg/kg of paracetamol were
administered during the study while a lower dosage of 10 mg/kg is commonly
used in the hospital and GP practice setting. This could have had an
impact on the difference between combination therapy versus paracetamol
alone measured in the study.