Physical methods for treating fever in children.
BACKGROUND
Health workers recommend bathing, sponging and other physical methods to treat fever in children and to avoid febrile convulsions. We know little about the most effective methods, or how these methods compare with commonly used drugs.


OBJECTIVE
To evaluate the benefits and harms of physical cooling methods used for managing fever in children.


METHODS
We searched the Cochrane Infectious Diseases Group specialized trials register (February 2003), the Cochrane Central Register of Controlled Trials (Issue 1, 2003), MEDLINE (1966 to February 2003), EMBASE (1988 to November 2002), CINHAL (1982 to February 2003), LILACS (February 2003), Science Citation Index (1981 to February 2003), and reference lists of articles. We also contacted researchers in the field.


METHODS
Randomized and quasi-randomized trials comparing physical methods with a drug placebo or no treatment in children with fever of presumed infectious origin. Studies where children in both groups were given an antipyretic drug were included.


METHODS
Two reviewers independently assessed trial methodological quality. One reviewer extracted data and the other checked the data for accuracy. Results were expressed as Relative Risk (RR) with 95% confidence intervals (CI) for discrete variables, and weighted mean differences for continuous outcomes.


RESULTS
Seven trials, involving 467 participants, met the inclusion criteria. One small trial (n = 30), comparing physical methods with drug placebo, did not demonstrate a difference in the proportion of children without fever by one hour after treatment in a comparison between physical methods alone and drug placebo. In 2 studies, where all children received an anti-pyretic drug, physical methods resulted in a higher proportion of children without fever at one hour (n=125, RR 11.8, CI 3.39 to 40.8). I; in a third study (n=130), which only reported mean change in temperature, no differences wereas detected. Mild adverse events (shivering and goose pimples) were more common in the physical methods group (3 trials, RR 5.09; CI 1.56 to 16.60).


CONCLUSIONS
A few small studies demonstrate that tepid sponging helps to reduce fever in children.
Meremikwu
M
M
Department of Paediatrics, University of Calabar, PMB 1115, Calabar, Cross River State, Nigeria. meremiku@skannet.com
Oyo-Ita
A
A
D000082:Acetaminophen / Q000627:therapeutic use; D000293:Adolescent; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D001494:Baths / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D017679:Cryotherapy / Q000009:adverse effects / Q000379:methods; D005334:Fever / Q000628:therapy*; D006801:Humans; D007223:Infant; D016032:Randomized Controlled Trials as Topic
D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen