Evidence map›Paper›PMID 40847562›Full record

SynthesisBritish journal of clinical pharmacology2025

Effectiveness and safety of interventions for fever-associated discomfort in children: A systematic review.

Antonio Corsello, Ilaria Alberti, Sara Farhanghi, Alessia Bonetti, Silvia Garattini, Anna Comotti, Paola Marchisio, Elena Chiappini, Gregorio Paolo Milani

Abstract readSystematic Review
In one paragraph

Synthesis in British journal of clinical pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. A primary healthcare approach to children with fever.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Antonio CorselloDepartment of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.ORCID https://orcid.org/0000-0003-4578-0066
Ilaria AlbertiPediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.ORCID https://orcid.org/0009-0004-5273-2331
Sara FarhanghiDepartment of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
Alessia BonettiDepartment of Health Sciences, Section of Paediatrics, University of Florence, Florence, Italy.
Silvia GarattiniDepartment of Health Sciences, Section of Paediatrics, University of Florence, Florence, Italy.
Anna ComottiOccupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Paola MarchisioDepartment of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
Elena ChiappiniDepartment of Health Sciences, Section of Paediatrics, University of Florence, Florence, Italy.
Gregorio Paolo MilaniDepartment of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.ORCID https://orcid.org/0000-0003-3829-4254

Funding

Italian Ministry of HealthUniversità degli Studi di Milano within the CRUI-CARE Agreement
6 · The paper itself

Abstract

aimsFever is one of the most frequent reasons for paediatric consultations. While traditionally managed by reducing body temperature, recent guidelines emphasize alleviating discomfort as the primary therapeutic goal. Although different interventions have been described to manage fever-associated discomfort in children, their effectiveness and safety has never been systematically analysed. The aim of this study was to review the evidence on the effectiveness and safety of pharmacological and nonpharmacological interventions for managing discomfort in febrile children.

methodsA systematic review was conducted following PRISMA guidelines (PROSPERO: CRD420250655721). PubMed, Embase and Cochrane Library were searched up to 31 January 2025, for studies involving children aged 29 days to 18 years that assessed interventions for fever-associated discomfort. Randomized controlled trials and observational studies were included. Risk of bias was assessed using Cochrane and STROBE tools. Results were synthesized narratively and grouped according to the type of intervention.

resultsEight studies (5 randomized controlled trials, 3 observational) involving 1877 children were included. Study designs, including dosage of antipyretics and quality varied across studies. Studies comparing ibuprofen and paracetamol provided conflicting results, while combination therapy (paracetamol + ibuprofen) appeared more effective than using a single drug in -one trial. Tepid sponging, despite reducing temperature, was associated with increased discomfort. No serious adverse events were reported.

conclusionPharmacological treatments appear effective and safe, whereas physical methods offer limited benefit. The available evidence is limited by the small number of studies, methodological heterogeneity, and concerns about risk of bias and outcome measurement inconsistency. New high-quality studies are needed to guide clinical practice for the management of fever-associated discomfort in children.

Indexed as

AntipyreticsFeverAcetaminophenAdolescentChildChild, PreschoolDrug Therapy, CombinationHumansIbuprofenInfantObservational Studies as TopicRandomized Controlled Trials as TopicTreatment OutcomeAcetaminophenAntipyreticsIbuprofenchildrendiscomfortfeveribuprofenparacetamolsystematic reviewtepid sponging

Identifiers

PMID40847562
PMCPMC12648366

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.