Personal Practice Antipyretic Therapy

Fever is among the most common manifestations of disease and antipyresis is one of the most usual therapeutic intervention undertaken. A variety of microbial products including endotoxins and exotoxins are recognized as exogenous pyrogens which induce host cells to produce mediators known as endogenous pyrogens. The best studied endogenous pyrogen is interleukin 1, others include tumor necrosis factor and interferons(l). Most known endogenous pyrogens act on the anterior hypothalamus to elicit local generation of prostaglandins. Fever represents the response of the host to a neurologic signal demanding thermal upregulation. Studies have shown temperature elevation to enhance several parameters of immune function like T cell activation, mononuclear production of leukocyte migration inhibition factor, neutrophil function and macrophage oxidative metabolism(2,3) while high temperatures prove deleterious by altering natural killer cell activity, generation of cytotoxic T lymphocytes and alteration in neutrophil morphology and function(4). While the clinical situation is much too complex to allow definite conclusions, the preponderance of evidence suggests that temperatures in the range of usual fever may ren-