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Paracetamol and ibuprofen provide comparable fever and pain relief in children with chronic diseases, but safety risks vary according to comorbidities and clinical condition.
Fever and pain continue to represent two of the most common and clinically significant symptoms affecting children with infections and long-term medical disorders, frequently disrupting quality of life and increasing caregiver concern. Paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs), particularly ibuprofen, remain central to pediatric symptom management because of their established antipyretic, analgesic, and anti-inflammatory properties.
The review was undertaken to critically assess the efficacy and safety of paracetamol and NSAIDs in children with chronic illnesses and to provide clinically relevant guidance for optimizing fever and pain management in high-risk pediatric populations. A comprehensive narrative review was supported by expert clinical interpretation to evaluate current evidence surrounding the use of paracetamol and NSAIDs, with particular focus on ibuprofen, in children with chronic medical conditions.
Available literature examining therapeutic benefits, adverse-event profiles, contraindications, infection-related risks, and disease-specific safety considerations across multiple pediatric disorders was systematically reviewed. The findings were subsequently integrated with clinical expertise to formulate practical, evidence-informed recommendations for pediatric care. Paracetamol and ibuprofen showed similar potency in controlling fever and pain in chronic diseases.
They were contraindicated in dehydration, renal impairment, and nephrotic syndrome relapse, with strict caution required in neonates and medically fragile patients. The review highlighted that managing fever and pain in children with chronic diseases required an individualized and careful approach. It found that both paracetamol and NSAIDs were effective, but their safety depended on the child’s underlying health conditions and overall risk factors. A tailored treatment plan had helped balance good symptom relief with the prevention of possible side effects.
Children
Efficacy and Safety of Paracetamol and NSAIDs for Fever and Pain Management in Children with Chronic Diseases: A Narrative Review
Gregorio Paolo Milani et al.
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