Management of fever

Woman and baby with a fever

Fevers are usually treated when a child is in discomfort.1

This applies to both children and adults. It’s also important to remember that fever is a sign that something is happening within the body, and treating it does not treat the underlying cause of the fever.1,2

However, children less than 3 months old, with a body temperature of ≥38.0°C, presenting with other “red flag” symptoms should be seen by a doctor.2,3

Managing fever in adults

Man with fever

Assessment of fever in adults

To determine if a patient has a fever, the most common and accurate route of taking a temperature in adults is a thermometer placed under the tongue (oral route).2

For practical clinical purposes, a patient is considered febrile or pyrexial if the oral temperature exceeds 37.5°C (99.5°F) or the rectal temperature exceeds 38°C (100.5°F).4

If the temperature is >39.4°C, the patient should seek medical attention.2

Do not forget to ask the patient for other symptoms they are experiencing to help determine the cause of the fever (such as “red flag” symptoms), and if they require any other treatment recommendations, other than medications to treat fever.2,5

Signs and symptoms

  • Non-pharmacological management of fever

    Pharmacist seeing a young child

    Adult patients may be recommended to do the following to help reduce feeling uncomfortable during a fever:5

    • Stay hydrated by drinking plenty of fluids
    • Water and juices will help recover fluid loss and combat dehydration that usually accompanies a fever
    • Taking rest to recover
    • Avoid heavy or strenuous activity that can increase the body temperature
    • Stay cool
    • Dressing with light clothing and keeping the room temperature cool may also help them feel more comfortable
  • Pharmacological management of fever

    Management of fever

    A low-grade fever in an adult does not require any medication.2 However, if the patient is feeling uncomfortable and has a high fever, over-the-counter antipyretics can be recommended.2

    The two most common are acetaminophen and ibuprofen.2,6 Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID).7

    Before recommending a particular treatment, check with your patient to see if there are any precautions, contraindications, or interactions with medicines they are currently taking that may prevent them from being able to take these medications.

Managing fever in children

Child with fever

Assessment of fever in children

For infants and children under 3 years of age, it is recommended that their temperature be taken rectally for the assessment of fever.3

For children older than 3 years of age, other methods of taking a temperature are orally (under the tongue), under the armpit, or in the ear. However, measuring a child’s temperature under the armpit or in the ear, are considered less accurate.3

As in adults, it is important to assess children for other symptoms accompanying the fever, as well as “red flag” symptoms that would require a referral to a doctor.3

Signs and symptoms

  • Non-pharmacological management of fever

    Man with child

    Parents of children with fever may be recommended to do the following to reduce their fever:1

    • Dress the child with light clothing
    • Excess clothing traps body heat, causing body temperature to rise
    • Encourage the child to drink plenty of fluids such as water or juice, or even eat popsicles
    • Give the child a lukewarm bath
    • Placing cold washcloths over certain areas of the body such as the forehead, groin, and wrists
  • Pharmacological management of fever

    Baby smiling

    The general recommendations for managing fever in children are that infants less than 3 months old with a fever of ≥38.0°C should be seen by a doctor regardless of other signs and symptoms.6

    Children >3 months old can be observed and/or treated with over-the-counter medications, unless they display any “red flag” symptoms.2,6*

    The primary goal of treating febrile children with analgesics is to improve the child’s overall comfort.8

    Acetaminophen and ibuprofen are two medications usually recommended as treatment options, as they are effective in reducing fever in children.3,8

    * Advil Pediatric Drops and Advil Pediatric Drops Fever from Colds or Flu are indicated for infants and children 4 months to 3 years of age.

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