REEVALUATION OF ANTIPYRETICS IN CHILDREN WITH ENTERIC FEVER

Background. The Committee on Infectious Diseases of the American Acade my of Pediatrics recommends withholding antipyretic administration to patients with enteric fever because of the risk of shock developing as a consequence. Objective. To evaluate the effects of antipyretics on blood pressure in children with enteric fever. Methods. A retrospectiv e review of medical records of patients admitted to Texas Children's H ospital from January, 1977, to October, 1997, with a diagnosis of ente ric fever. All febrile episodes were evaluated for the use of antipyre tics and evidence of hypotension or cardiovascular decompensation asso ciated with them. Results. Twenty-nine patients with enteric fever wer e identified. Salmonella typhi caused 23 of these infections. Antipyre tics were used in all but one patient. We did not find any association between the use of antipyretics and the development of hypotension. O ne patient developed shock and adult respiratory distress syndrome >36 h after start of antibiotic therapy and unrelated to fever or antipyr etic use. Two patients had evidence of dehydration. No other complicat ions occurred. Conclusions. We did not find any complications associat ed with the use of acetaminophen or ibuprofen in children with enteric fever. The effects of antipyretics in enteric fever should be further studied.