Hilary Butler’s quotes on giving analgesics during illness -
PARACETAMOL. (USA TYLENOL, IBUPROFEN etc)
Your child is scratchy, your child has a temperature, your child is irritable,
and you ring the doctor's surgery, and the voice on the other end says what it
always says" "Just give Pamol, dear, and come back tomorrow if
you are still worried."
Well, tomorrow just might be too late. Why might that be? Could the
increase in all forms of meningitis and other infectious disease complications
and deaths be because for the last 40+ years, the first thing parents do at the
slightest sign of a temperature is push
paracetamol? I believe so, because what you weren't told was this:
EXTRACTS FROM MEDICAL LITERATURE:
"Not all fevers need to be treated but many physicians do so to relieve
parental concern." (Eur J Ped 1994 Jun; 153 (6): 394-402) time
to get a grip, parents.....
"An elevation in temperature following bacterial infection results in a
significant increase in host survival" (Science 1975 Apr 11; 188 (4184):
166-8)
"Many components of the nonspecific host defense response to infection
such as leukocyte mobility, lymphocyte transformation, and the effects of
interferon, appear to be enhanced by elevations in temperature that simulate
moderate fevers. In addition, some
evidence indicates that a fever in conjunction with the changes in plasma iron
levels known to occur during infections is a synergistic host defense
response." (Pediatrics 1980, No: 66 (5) : 720 - 723)
"Parental fever phobia and its correlates...surprising, higher
socioeconomic status was not associated with a lesser degree of fever
phobia...undue fear and overly aggressive treatment of fever are epidemic among
parents of infants and young children, even among the highly educated and
well-to-do. Considerable effort will be required
on the part of pediatricians and other child health workers to reeducate that
parents about the definition, consequences and appropriate treatment of
fever." (Pediatrics 1985 June;75 (6) 1110-1113)
"There is no convincing evidence that naturally occurring fevers are
harmful. In contrast, animal studies have shown that fever helps animals to
survive and infection whereas antipyresis increases mortality. Moreover
there is considerable in vitro evidence that a
variety of human immunological defenses function better at febrile temperatures
than at normal one." (The Lancet, Volume 337, March 9, 1991)
"Many cytokines are endogenous mediators of fever including interleukin
(IL) -, 1 beta, IL-6 and others. Tumor necrosis factor-alpha may be both
an endogenous pyrogen and an endogenous antipyretic or cryogen."
(Neuroimmunomodulation 1995 Jul-Aug; 2 (4): 216-223)
"There is overwhelming evidence in favor of fever being an adaptive host
response to infection... as such, it is probable that the use of
antipyretic/anti-inflammatory/analgesic drugs, when they lead to suppression of
the fever, result in increased morbidity and mortality during most
infections; this morbidity and mortality may not be apparent to most
health care workers..." Infect Dis Clin North Am 1996 Mar;10(1) : 1-20.)
Acetaminophen can induce pneumonia... “These
findings suggest that allergic mechanism was involved in the pathogenesis of
the pneumonitis. Underlying immunological disorders may have enhanced the
occurrence." Nihon Kyobu Shikkan Gakkai Sasshi 1997 Sep; 35 (9)
974-9) There are other reports of this as well...
"The results suggest that lung disease (rheumatoid lung) associated with
collagen vascular diseases may be exacerbated by drug-induced (acetaminophen)
pneumonitis." Nihon Kyobu Shikkan Gakkai Sasshi 1997 Oct; 35 (10)
1113-1118)
"Despite our lack of knowledge about its therapeutic mechanism, it has
been claimed to be a safe drug, especially for children... paracetamol syrup
(presumably for children) is extensively prescribed in large
volumes...There is mounting evidence that paracetamol is not the benign drug
that it was formally thought to be... We would question the whole rationale of
prescribing the drug in near epidemic proportions. If it is to be used as
a placebo, then it is a very dangerous placebo... The whole place of
paracetamol prescribing for children has been questioned. While there is
little concern about its use in the short term as an analgesic, there is considerable
controversy over its use as an antipyretic....there is little evidence to
support the use of paracetamol to treat fever in
patients without heart or lung disease. Paracetamol may decrease antibody
response to infection and increase morbidity and mortality in severe
infections...too many parents and health workers think that fever is bad and
needs to be suppressed by paracetamol when, indeed, moderate fever may improve
the immune response...the use of paracetamol in children with acute infection
did not result in an improvement in mood, comfort, appetite or fluid
intake." (Family Practice, Volume 13, No 2, 1996)
"Fever is rarely harmful. Only extremely high fevers of 42.2C or 108
F or higher have been known to cause brain damage. Only fevers of 40.5C
or 105F and higher need
immediate attention, mainly because they are a clue that a
serious infection could be present "(such as meningitis) (Sunday Star
Times, May 3, 1998, C3)
"Paracetamol has no antipyretic benefits over mechanical antipyresis alone
in ..malaria. Moreover, paracetamol prolongs parasite clearance time,
possible by decreased production of TNF and oxygen radicals. " (Lancet
1997; 350:704-709)
"The data suggest that frequent administration of antipyretics to children
with infectious disease may lead to a worsening of their illness." (Acta
Paed. Jpn 1994 Aug; 36 (4) 375-378)
"Fever is an important indicator of disease and should not be routinely
suppressed by antipyretics...fever may actually benefit the host defense
mechanism...fever is short-lived and causes only minor discomfort...routine
antipyretic therapy should be avoided but may be necessary in individual
patients with cardiovascular or neurologic disorders."(Infect Dis Clin
North Am 1996 Mar; 10 (1) 211-216)
"Studies of bacterial and viral-infected animals have shown that moderate
fevers decrease morbidity and increase survival rate" (Yale J Biol
Med 1986 Mar-April; 59 (2) : 89-95)
"Antipyretic drugs are effective in diminishing fever, but have
significant side effects and may suppress signs of ongoing
infections" (Arch Intern Med 1990, Aug; 150 (8): 1589-1597)
Meningococcal Disease: "use of analgesics were associated with
disease...analgesic use was defined as analgesics taken in the past 2 weeks,
excluding, for cases, those taken for identified early symptoms of
meningococcal disease. These analgesics were predominantly acetaminophen
products......because analgesics showed a stronger relationship with
meningococcal disease, the use of analgesics may be a better measure of more
severe illness than reported individual symptoms....we cannot exclude the
possibility that acetaminophen use itself is a risk factor for meningococcal
disease" (Ped Infec Dis, Oct 2000, Vol 19, No 10, 983-990)
"Antipyretics prolong illness in patients with Influenza A.... The
duration of illness was significantly prolonged." Pharmacotherapy
2000, 20: 417-422)
"These results suggest that the systematic suppression of fever may not be
useful in patients without severe cranial trauma or significant
hypoxemia. Letting fever take its natural course does not seem to harm
patients with systemic inflammatory response
syndrome, or influence the discomfort level AND MAY SAVE COSTS."
(wow!!!) (Arch Intern Med 2001, Jan 8; 161 (1) 121-123)
And last, but not least, if you want to turn chickenpox into fulminant
necrotising fasciitis - go ahead - and give Tylenol/paracetamol. (Pediatr
I(Pediatrics Vol 103, No 4, April 1999, 783-784 and 785-790) (Infect
Med1999 16 (5):307) Just two of many
references for antipyretic induced complications of chickenpox.
So who, in their right mind, would want to play Russian Roulette with their
child's health? Not me, and I couldn't give a toss what the label says,
or what the experts say, or even those dinky little ads on TV - because their
own literature has given enough warning to totally change the face of care of
children with fevers, yet THEY HAVE DONE NOTHING to try
to change parents perceptions on fever, or the use of paracetamol/Tylenol.
And why is that? Follow the money. Over the counter antipyretics
are the best money spinner there is. Wall Street rules. Again.
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