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25-11-2012 | General practice | Article

NICE updates on fever in under-5s


NICE Guideline consultation: Feverish illness in children

medwireNews: GPs and other healthcare professionals are to receive updated guidance from NICE on the management of fever in young children.

Draft guidance out this month retains the bulk of previous recommendations, but takes into account new evidence on the use of heart rate to predict risk of serious illness, as well as on combining or alternating paracetamol and ibuprofen.

According to this, doctors should still use the traffic light system for symptoms and signs, but also consider that children with tachycardia, based on the Advance Paediatric Life Support (APLS) criteria, are in at least an intermediate-risk group for serious illness.

And regarding therapy, paracetamol or ibuprofen should be continued only as long as the child appears distressed and the drugs should not be used simultaneously. Doctors should consider alternating these agents if distress persists or recurs before the next dose is due.

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE, explained to the press that since the publication of the first national guideline on assessment of children with fever in 2007, management of young children presenting with fever ‑ and their outcomes ‑ has continued to vary across the UK.

"Updating the NICE guideline to take into account new evidence will ensure that it remains current and relevant. Not all children will need to be taken to hospital and this guideline will help doctors, nurses, pharmacists and other healthcare professionals to pick up the high-risk symptoms that indicate a child needs urgent medical attention," he said.

"It will also help to empower parents so they can work in partnership with healthcare professionals to care for children with a feverish illness."

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Caroline Price, Senior medwireNews Reporter