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. 2003;2003(2):CD004264.
doi: 10.1002/14651858.CD004264.

Physical methods for treating fever in children

M Meremikwu  1 , A Oyo-Ita
Affiliations

Physical methods for treating fever in children

M Meremikwu et al. Cochrane Database Syst Rev. 2003.

Abstract

Background: Health workers recommend bathing, sponging and other physical methods to treat fever in children and to avoid febrile convulsions. We know little about the most effective methods, or how these methods compare with commonly used drugs.

Objectives: To evaluate the benefits and harms of physical cooling methods used for managing fever in children.

Search strategy: We searched the Cochrane Infectious Diseases Group specialized trials register (February 2003), the Cochrane Central Register of Controlled Trials (Issue 1, 2003), MEDLINE (1966 to February 2003), EMBASE (1988 to November 2002), CINHAL (1982 to February 2003), LILACS (February 2003), Science Citation Index (1981 to February 2003), and reference lists of articles. We also contacted researchers in the field.

Selection criteria: Randomized and quasi-randomized trials comparing physical methods with a drug placebo or no treatment in children with fever of presumed infectious origin. Studies where children in both groups were given an antipyretic drug were included.

Data collection and analysis: Two reviewers independently assessed trial methodological quality. One reviewer extracted data and the other checked the data for accuracy. Results were expressed as Relative Risk (RR) with 95% confidence intervals (CI) for discrete variables, and weighted mean differences for continuous outcomes.

Main results: Seven trials, involving 467 participants, met the inclusion criteria. One small trial (n = 30), comparing physical methods with drug placebo, did not demonstrate a difference in the proportion of children without fever by one hour after treatment in a comparison between physical methods alone and drug placebo. In 2 studies, where all children received an anti-pyretic drug, physical methods resulted in a higher proportion of children without fever at one hour (n=125, RR 11.8, CI 3.39 to 40.8). I; in a third study (n=130), which only reported mean change in temperature, no differences wereas detected. Mild adverse events (shivering and goose pimples) were more common in the physical methods group (3 trials, RR 5.09; CI 1.56 to 16.60).

Reviewer's conclusions: A few small studies demonstrate that tepid sponging helps to reduce fever in children.

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Conflict of interest statement

We certify that we have no affiliations with or involvement in any organization or entity with a direct financial interest in the subject matter of the review (eg employment, consultancy, stock ownership, honoraria, expert testimony).

Figures

Analysis 1.1
Analysis 1.1
Comparison 1 Physical methods compared to control, Outcome 1 Resolution of fever by 1 hour.
Analysis 1.2
Analysis 1.2
Comparison 1 Physical methods compared to control, Outcome 2 Resolution of fever by 2 hours.
Analysis 1.3
Analysis 1.3
Comparison 1 Physical methods compared to control, Outcome 3 Adverse events.
Analysis 1.4
Analysis 1.4
Comparison 1 Physical methods compared to control, Outcome 4 Mean temperature change.
Analysis 2.1
Analysis 2.1
Comparison 2 Iced water compared to tepid sponging (paracetamol given to both arms), Outcome 1 Resolution of by 1 hour.
Analysis 2.2
Analysis 2.2
Comparison 2 Iced water compared to tepid sponging (paracetamol given to both arms), Outcome 2 Resolution of fever by 2 hours.
Analysis 2.3
Analysis 2.3
Comparison 2 Iced water compared to tepid sponging (paracetamol given to both arms), Outcome 3 Adverse events.
Analysis 3.1
Analysis 3.1
Comparison 3 Alcohol compared to tepid sponging (paracetamol given to both arms), Outcome 1 Resolution of fever by 1 hour.
Analysis 3.2
Analysis 3.2
Comparison 3 Alcohol compared to tepid sponging (paracetamol given to both arms), Outcome 2 Resolution of fever by 2 hours.
Analysis 3.3
Analysis 3.3
Comparison 3 Alcohol compared to tepid sponging (paracetamol given to both arms), Outcome 3 Adverse events.
See this image and copyright information in PMC

References

References to studies included in this review

    1. Friedman AD, Barton LL. Efficacy of sponging versus acetaminophen for reduction of fever. Pediatric Emergency Care 1990;6(1):6‐7. - PubMed
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