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Pediatrics. 2018 Nov;142(5). pii: e20181009. doi: 10.1542/peds.2018-1009. Epub 2018 Oct 8.

Acetaminophen and Febrile Seizure Recurrences During the Same Fever Episode.

Author information

1
Department of Pediatrics, Hirakata City Hospital, Hirakata, Osaka, Japan; wildwind1980@live.jp.
2
Department of Pediatrics, Hirakata City Hospital, Hirakata, Osaka, Japan.
3
Department of Child Neurology, Tanabe Children's Clinic, Hirakata, Osaka, Japan; and.
4
Department of Pediatrics, Osaka Medical College, Takatsuki, Osaka, Japan.

Abstract

OBJECTIVES:

To confirm the safety of using acetaminophen for febrile seizures (FSs) and to assess its efficacy in preventing FS recurrence during the same fever episode.

METHODS:

In this single-center, prospective, open, randomized controlled study, we included children and infants (age range: 6-60 months) with FSs who visited our hospital between May 1, 2015, and April 30, 2017. The effectiveness of acetaminophen was examined by comparing the recurrence rates of patients in whom rectal acetaminophen (10 mg/kg) was administered every 6 hours until 24 hours after the first convulsion (if the fever remained >38.0°C) to the rates of patients in whom no antipyretics were administered. No placebo was administered to controls. The primary outcome measure was FS recurrence during the same fever episode.

RESULTS:

We evaluated 423 patients; of these, 219 were in the rectal acetaminophen group, and 204 were in the no antipyretics group. In the univariate analysis, the FS recurrence rate was significantly lower in the rectal acetaminophen group (9.1%) than in the no antipyretics group (23.5%; P < .001). Among the variables in the final multiple logistic regression analysis, rectal acetaminophen use was the largest contributor to the prevention of FS recurrence during the same fever episode (odds ratio: 5.6; 95% confidence interval: 2.3-13.3).

CONCLUSIONS:

Acetaminophen is a safe antipyretic against FSs and has the potential to prevent FS recurrence during the same fever episode.

PMID:
30297499
DOI:
10.1542/peds.2018-1009

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

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