Q&A: What kind of medicine is best for a persistent fever?
My 2-year-old has had a fever for the past three days and Tylenol only works for an hour. This is the third fever in three months. Any ideas on different medication to try?
Before discussing fevers in general, let me state that in a child aged 2 or under, a fever of more than three days merits a call to your doctor to try to uncover the cause.
That said, fevers in children are common, but not very specific. They tell us only that the body has identified an invader and is trying to use heat to weaken or destroy it. It doesn’t tell us whether an inpending infection will be serious or not. It doesn’t tell us where an infection is. We can’t even rely on the fact that a high fever is necessarily more worrisome, since different bodies run different fevers to the same germ! The fever itself usually doesn’t cause any harm, unless it is pushing towards 105 or 106 F. In fact, as mentioned above, fever is part of the body’s defense system.
In general, a small child, one who looks sick, one with other worrisome symptoms or one with a fever of more than a few days should be evaluated.
As far as temperature control is concerned, there are three effective types of medications: aspirin, acetominophen (Tylenol) and ibuprofen (Motrin and Advil). Aspirin is not used in children except in rare instances under a doctor’s supervision.
Acetominophen and ibuprofen provide good fever control but must be dosed correctly as they are both toxic when overdosed. Acetominophen is meant to be used no more frequently than every four to six hours, ibuprofen every six to eight hours. We used to think alternating the two gave superior fever control, but recent studies failed to prove this. Dosing charts always appear on the containers, but for children under two, you are often asked to call your doctor for the dose. Always use the appropriate dosing instrument (dropper or syringe) and remember that infant products are usually more, not less, concentrated than toddler products.