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Ibuprofen reduces fever more rapidly at 30 minutes, but both ibuprofen and paracetamol are equally effective in managing fever over time in patients with sepsis and septic shock.
A randomized clinical trial led by Safa Dönmez et al. compared the fever-reducing effects of intravenous (IV) ibuprofen and paracetamol in adults suffering from sepsis or septic shock. In total, 113 patients (aged 18 and older), all presenting with a fever of 38.3 °C or higher, were randomly allocated to get either 400 mg of IV ibuprofen or 1 g of IV paracetamol. Researchers monitored body temperature at baseline and at 30, 60, and 120 minutes following the intervention.
The primary outcomes included changes in temperature and the proportion of patients reaching a temperature below 38.3 °C. Secondary endpoints evaluated adverse effects, complications, and changes in severity scores (Quick Sequential Organ Failure Assessment [qSOFA], National Early Warning Score 2 [NEWS2], Modified Early Warning Score [MEWS]).
Both medications successfully lowered fever over time, and no prominent differences were noted between the two groups in terms of baseline characteristics, infection sources, or severity scores. Although ibuprofen illustrated a quicker fever-reducing effect at the 30-minute mark, both drugs were similarly effective by 120 minutes. Pulmonary infections were the most common cause of sepsis, followed by urinary tract infections, with no vital differences in infection source distribution between the groups.
The findings suggest that both ibuprofen and paracetamol are safe and effective for fever management in those with sepsis and septic shock, with ibuprofen offering a slightly faster initial response but no sustained superiority.
Eurasian Journal of Emergency Medicine
Comparison of Ibuprofen and Paracetamol for Fever Management in Sepsis and Septic Shock: A Randomized Controlled Trial
Safa Dönmez et al.
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