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 | |