Is combining or alternating antipyretic therapy more beneficial than monotherapy for febrile children?

adequate double blinding,7 and the use of small antipyretic doses that may have biased the results in favour of the alternating regimen.7 In addition, the mean difference in temperature between the alternating and monotherapy groups was clinically insignificant (≤1°C) in two studies.7 8 No significant adverse events were reported. However, objective laboratory screening for liver and renal toxicities was performed in one study only,7 and the other investigators monitored toxicity clinically. Because classic laboratory testing with urine analysis or blood urea nitrogen and creatinine may fail to detect early renal toxicity, the safety of antipyretic combinations remains uncertain.