Does the use of antipyretics prolong illness? A systematic review of the literature and meta-analysis on the effects of antipyretics in acute upper and lower respiratory tract infections - 27/07/23
Highlights |
• | Fever contributes to the inflammatory response counteracting infections. It is a physiological defense mechanism common to all vertebrates. |
• | It is possible that antipyretics could delay the healing of some parasitic, viral or bacterial infections. What are the risks and benefits an antipyretic treatment? |
• | In this meta-analysis, the use of antipyretics was not shown to prolong illness in upper and lower respiratory tract infections. |
• | The symptomatic efficacy of antipyretics must be weighed against their adverse events, particularly when fever or certain associated symptoms are well-tolerated. |
Abstract |
Objective |
Fever contributes to the inflammatory response; in some infections, antipyretics could prolong the illness. The objective of our study was to evaluate the impact of antipyretic treatments on the evolution of acute upper and lower respiratory tract infections (RTI).
Method |
A systematic literature review of randomized controlled trials (RCTs) with meta-analysis was conducted. Our primary endpoint was the time to recovery from illness. Our prespecified secondary endpoints were quality of life, duration and number of fever episodes, repeated medical visits, and adverse events.
Results |
Out of the 1466 references found, 25 RCTs were included. There were two studies assessing mean fever clearance time, and five studies examining the duration of symptoms associated with the illness studied. No statistically significant differences were found when pooling the results of the different studies. The assessment of adverse events showed a significant difference disadvantaging non-steroidal anti-inflammatory drugs. No meta-analysis could be performed for our other secondary endpoints. The quality of the evidence is limited by the small number of studies included for our primary endpoint and by heterogeneity between the studies.
Conclusion |
Our results suggest that the use of antipyretics does not prolong or shorten illness duration in acute upper and lower RTI. The symptomatic efficacy of antipyretics must be weighed against their adverse effects, particularly when fever is well-tolerated.
Le texte complet de cet article est disponible en PDF.Keywords : Antipyretics, Acute upper and lower respiratory tract infection, Illness duration, Meta-analysis, Recovery
Plan
Vol 53 - N° 5
Article 104716- août 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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