METHODS: We systematically searched the literature from 1966 to 1998 using electronic data base (MEDLINE, MEDSCAPE, COCHRANE, HERDIN and University-based clinical trial databases), manually searched local libraries, checked references of retrieved articles to screen studies for inclusion. Letters were also sent to authors to retrieved relevant data and identify other studies Included were randomized controlled trials among children (less than 18 years old) with fever comparing the antipyretic effect of ibuprofen and paracetamol. Study quality was evaluated by three independent reviewers and data were extracted by three independent extractors. Disagreement was resolved by discussion and votation. Data was analyzed using Revman 3.0.

RESULTS: For the temparature monitoring, a total of 454 patients from 7 studies were included. Ibuprofen had a greater reduction in temparature as compared to paracetamol. The standardized mean difference between ibuprofen and paracetamol at 15 to 30 minutes, 1,2,4,6 and 8 hours after intake were -0.41, -0.527, -0.666, -0.770, -0.546, -0.486 and -0.402 respectively and all were statistically significant. The overall side effects were similar between the two drugs (Peto odds ratio =1.00; 95 percent Cl=0.87,1.15). The side effects were based on the observation of a total of 84,844 patients from ten studies.

CONCLUSION: The results of this meta-analysis showed that ibuprofen as compared to paracetamol produced 1) greater reduction in temparature among children with fever (overall difference is statistically significant), 2) faster onset of action (difference in effect is still statistically significant after 15 minutes) and 3) longer duration of action (difference in effect is still statistically significant after eight hours). The results also showed that ibuprofen had similar incidence of overall side effects as compared to paracetamol.

The Filipino Family Physician, 1998 36 ( 4 ) pages 121-131