EFFICACY OF TEPID SPONGING VERSUS PARACETAMOL IN REDUCING TEMPERATUREIN FEBRILE CHILDREN

A block randomized clinical trial to compare the efficacy of tepid spo nging with the use of paracetamol in febrile children was undertaken a t the Queen Elizabeth Central Hospital, Blantyre. Eighty children aged between 6 and 54 months with axillary temperatures of between greater than or equal to 38.5 degrees C and less than or equal to 40 degrees C and a clinical diagnosis consistent with upper respiratory tract inf ection and/or malaria were block randomized to receive either oral par acetamol (15 mg/kg) or tepid sponging. Children receiving tepid spongi ng were sponged from head to toe (except the scalp) by leaving a thin layer of water on the body. If the body became dry it was repeated and continued until the axillary temperature fell to <38.5 degrees C. Axi llary temperature and assessment of discomfort (convulsions, crying, i rritability, vomiting and shivering) were recorded every 30 minutes fo r 2 hours. A significantly greater and more rapid reduction of fever w as demonstrated with paracetamol than with tepid sponging. Tepid spong ing without antipyretics is often used to reduce fever, but our result s suggest that this is effective only during the Ist 30 minutes. Parac etamol is clearly more effective than tepid sponging in reducing body temperature in febrile children in a tropical climate.