Effect of antipyretic therapy on the duration of illness in experimental influenza A, Shigella sonnei, and Rickettsia rickettsii infections.
OBJECTIVE
To determine whether antipyretic therapy prolongs the course of experimental influenza A, Shigella sonnei, and Rickettsia rickettsii infections.


METHODS
Retrospective observational study.


METHODS
University Center for Vaccine Development.


METHODS
Fifty-four volunteers with experimentally induced influenza A, 45 with S. sonnei, and 21 with R. rickettsii infections participated.


METHODS
Subjects from the six influenza A studies were challenged intranasally. If they met certain criteria, they were offered aspirin or acetaminophen for symptomatic relief. Subjects from the three Shigella studies were challenged with the bacteria and then given trimethoprimsulfamethoxazole. Acetaminophen also could be administered. In the one R. rickettsii trial, subjects were inoculated intradermally and treated with tetracycline. Again, acetaminophen was administered for symptomatic relief.


RESULTS
Data, excerpted from subjects' study records, were evaluated using Wilcoxon tests, Spearman's correlation coefficients, and multiple regression analysis. Two-tailed hypotheses with a p value of 0.05 were used for all of the analyses. There was a striking correlation between antipyretic therapy and duration of illness in subjects infected with influenza A and S. sonnei, but not R. rickettsii.


CONCLUSIONS
Multivariate analysis suggested that antipyretic therapy prolonged illness in subjects infected with influenza A, but its use was the result of prolonged illness in those infected with S. sonnei. The precise nature of these relationships requires a prospective, randomized, placebo-controlled trial.
Plaisance
K I
KI
School of Pharmacy, University of Maryland, Baltimore, USA.
Kudaravalli
S
S
Wasserman
S S
SS
Levine
M M
MM
Mackowiak
P A
PA
D000082:Acetaminophen / Q000009:adverse effects* / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects* / Q000627:therapeutic use; D001241:Aspirin / Q000009:adverse effects* / Q000627:therapeutic use; D004405:Dysentery, Bacillary / Q000503:physiopathology*; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D009980:Influenza A virus; D007251:Influenza, Human / Q000503:physiopathology*; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012284:Rickettsia rickettsii; D012373:Rocky Mountain Spotted Fever / Q000503:physiopathology*; D012764:Shigella sonnei
D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen; D001241:Aspirin