Comparison between Ibuprofen and Acetaminophen in the Treatment of Infectious Fever in Children: A Meta-Analysis

BACKGROUND: To evaluate ibuprofen and acetaminophen in the treatment of infectious fever in children. METHODS: We searched randomized controlled trials and retrospective cohort studies comparing ibuprofen and acetaminophen in the treatment of infectious fever among children. Data were extracted from eligible studies. We sought to evaluate temperature after taking drugs in 1, 2, and 4 hours, respectively, and analyzed the adverse events. Results were expressed as mean difference(MD) and risk ratio (RR) with 95% confidence intervals. RESULTS: Ten studies were included in this study with a total of 1773 patients. The results showed that acetaminophen had higher temperature than ibuprofen after 1 hour (The overall mean difference was −0.29 with 95% CI (−0.49, −0.09). The P value of the overall effect was = 0.004, I(2) = 91%), 2 hours (MD = −0.46, 95% CI (−0.67, −0.25), P < 0.00001, I(2) = 95%), and 4 hours (MD = -0.57, 95% CI (−0.82, −0.33), P < 0.00001, I(2) = 97%). There is no difference between two drugs in the adverse events (RR = 0.8, 95% CI (0.52, 1.24), P = 0.32, I(2) = 0%). The sensitivity analysis and funnel plot showed that our study was robust and had low publication bias. CONCLUSION: Our study suggested that ibuprofen is more effective than acetaminophen in children with infectious fever.