Comparison of the antipyretic efficacy of intravenous paracetamol and intravenous ibuprofen in the emergency department

Introduction: Fever is one of the most common causes of admission to the emergency department. Control of body temperature, especially fever, is very important for patient prognosis and comfort. Paracetamol and ibuprofen are safe and effective agents for fever control. In the literature, there are many studies evaluating the antipyretic efficacy of paracetamol and ibuprofen especially in children and analgesic efficacy in adults, but to our knowledge, there are limited studies comparing the antipyretic efficacy of iv (intravenous) paracetamol and iv ibuprofen in adults. In our study, we aimed to compare the antipyretic efficacy of iv paracetamol and iv ibuprofen in adults. In this way, we aim to answer the question of whether iv ibuprofen can be an alternative to iv paracetamol, which clinicians use frequently in practice in fever management. We think that this alternative can make the clinician's work easier, especially in liver diseases or in patients with paracetamol allergy. Material-method: Our research is a retrospective study. Patients aged 18 years and over who were found to have high fever between 01.07.2021 and 01.07.2022 in the Emergency Department of Manisa Celal Bayar University Medical Faculty Hospital were evaluated. All parameters were recorded by scanning patient files over the Hospital Information Management System (HIMS). Results: In our study, we analyzed the data of 148 patients, 84 of whom were men and 64 were women. Of the 148 patients with fever that we included in our study, 29 were admitted to the emergency department with chills, 56 with sore throat, 14 with malaise, and 49 with other symptoms. A statistically significant relationship was found between drug groups and outcome (χ2=13.680; p=0.000). It was determined that 23 patients (30.7%) in the paracetamol group were hospitalized in the service or intensive care unit, and 68 patients (93.2%) in the ibuprofen group were discharged. A statistically significant difference was found in the amount of fever reduction at the 0-15th minute according to the drug groups (Z=-3.437; p=0.001). The 0-15th minute decrease in fever in the ibuprofen group was significantly higher than in the paracetamol group. There was no statistically significant difference in 15-30th minutes fever reduction according to drug groups (p>0.05). A statistically significant difference was found in terms of the amount of fever reduction in 30-60th minutes according to the drug groups (Z=-3,758; p=0.000). The amount of fever reduction at 30-60th minutes in the paracetamol group was significantly higher than those in the ibuprofen group. There was no statistically significant difference in the 0-60th minute fever difference values according to the drug groups (p>0.05). Conclusion: In our study, it has been shown that ibuprofen is more effective especially in the first minutes. It has been proven that ibuprofen, whose rapid antipyretic property is statistically more significant than paracetamol, can be used to reduce the length of stay of patients in the emergency room.