title: Pharmacotherapy of fever control among hospitalized adult patients.
abstract: BACKGROUND
  Fever is common and associated with increased mortality among hospitalized adults. This article will review the pharmacotherapy of commonly prescribed antipyretic drugs including the rationale for and against temperature control in febrile adults, as well as the evidence associated with fever control in specific patient populations.
  
  
  METHODS
  Though fever is common, the molecular basis of pyrexia, and the interaction of these pathways with commonly prescribed antipyretic drugs are not fully understood. Furthermore, while experimental and clinical studies clearly demonstrate that pyrexia is harmful in select patients, available clinical trial data are unable to suggest an evidence-based approach to the treatment of fever. Interestingly, this also applies to patients with an acute neurologic injury wherein the treatment of fever with antipyretic therapy has become a common management strategy.
  
  
  CONCLUSIONS
  Few adequately powered clinical trials have investigated temperature control strategies in febrile patients. Therefore, it is not possible to define an evidence-based approach to the control of fever in hospitalized adults. Further clinical and translational research is required to identify the patients most likely to benefit from a strategy of fever control versus permissive hyperthermia, and to determine the antipyretic therapies associated with the greatest improvement in outcome.
authors.affiliation: University of Calgary, Department of Critical Care Medicine, ICU Administration, Peter Lougheed Centre, 3500 26th Ave NE T1Y 6J4 Calgary, Alberta, T1Y 6J4, Canada. Daniel.niven@albertahealthservices.ca
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Niven
authors.forename: Kevin B
authors.initials: KB
authors.lastname: Laupland
mesh_terms: D000328:Adult; D058633:Antipyretics / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D019317:Evidence-Based Medicine; D005334:Fever / Q000188:drug therapy* / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans
chemical_list: D058633:Antipyretics