Do antipyretics prolong febrile illness?

Abstract

Antipyretics appear to have minor and variable effects on the course of febrile illness. Aspirin and acetaminophen do not prolong the course of rhinovirus illness, although they may prolong the period of viral shedding and worsen nasal congestion (strength of recommendation [SOR]: A-, based on small randomized controlled trials). Acetaminophen did not affect symptoms, overall condition, or time to complete healing in children with varicella, although it increased the time to total scabbing of lesions (SOR: A, based on a small randomized controlled trial). Aspirin and acetaminophen may prolong influenza A illness (SOR: C, based on a poor-quality, retrospective observational study). Acetaminophen may prolong the course of Shigella sonnei infection (SOR: B-, based on a small retrospective cohort study). It does not affect malaria cure rate, and there are insufficient data to assess clearance of Plasmodium falciparum (SOR: C, based on small randomized controlled trials with heterogeneous results).