title: Pilot study of the use of Yin Qiao San in children with conventional antipyretic hypersensitivity.
abstract: BACKGROUND
  Children with a diagnosis of cross-reactive hypersensitivity to both paracetamol and nonsteroidal anti-inflammatory drugs are limited in their choice of antipyretics.
  
  
  OBJECTIVE
  The aim of this pilot study is to evaluate the feasibility of using a Chinese proprietary medicine, Yin Qiao San (YQS), for fever relief.
  
  
  METHODS
  A single centre, open label, prospective clinical trial exploring the tolerability and feasibility of using YQS for fever relief in children who are unable to use conventional antipyretic medications. Children between 1-18 years of age with hypersensitivity to multiple antipyretics were recruited. Eligible participants underwent an oral provocation test with YQS. Children who passed the oral provocation test were instructed to take a prescribed dose of YQS when the temperature was >38.0℃ and continued till the fever settled. Time taken for fever resolution and any adverse events were collected.
  
  
  RESULTS
  A total of 21 children, mean age 10.7 years, had a diagnosis of paracetamol and ibuprofen hypersensitivity. All except one patient successfully tolerated an oral challenge of YQS. Of the 88 doses of YQS taken for fever over 38.0℃, 16 (18%) had documented temperature reduction 2 hours after ingestion and 30 (34%) had documented temperature reduction 4 hours after ingestion. There were 2 reports of urticaria after YQS use which were attributed to flare of recurrent spontaneous urticaria during the illness. None of the patients developed symptoms of circulatory compromise or respiratory distress.
  
  
  CONCLUSIONS
  YQS is generally well tolerated in patients with paracetamol and ibuprofen hypersensitivity.
authors.affiliation: Department of Paediatric Medicine, Allergy Service, KK Women's and Children's Hospital, Singapore 229899, Singapore.
authors.forename: Woei Kang
authors.initials: WK
authors.lastname: Liew
authors.affiliation: Department of Paediatric Medicine, Allergy Service, KK Women's and Children's Hospital, Singapore 229899, Singapore.
authors.forename: Wenyin
authors.initials: W
authors.lastname: Loh
authors.affiliation: Department of Paediatric Medicine, Allergy Service, KK Women's and Children's Hospital, Singapore 229899, Singapore.
authors.forename: Wen Chin
authors.initials: WC
authors.lastname: Chiang
authors.affiliation: Department of Paediatric Medicine, Allergy Service, KK Women's and Children's Hospital, Singapore 229899, Singapore.
authors.forename: Anne
authors.initials: A
authors.lastname: Goh
authors.affiliation: Department of Paediatric Medicine, Allergy Service, KK Women's and Children's Hospital, Singapore 229899, Singapore.
authors.forename: Oh Moh
authors.initials: OM
authors.lastname: Chay
authors.affiliation: Allergy and Clinical Immunology Unit, Sheba Medical Center, Tel Hashomer 5262100, Israel.
authors.forename: Mona
authors.initials: M
authors.lastname: Iancovici Kidon
keywords: Acetaminophen; Anti-Inflammatory Agents, Non-Steroidal; Child; Cyclooxygenase 1; Herbal Medicine; Hypersensitivity