Febrile seizure management and effectiveness of prevention with antipyretics

Background: Before reaching the age of 5, 2–5% of children will have had a febrile seizure. Most are categorised as simple but they can be complex and carry the risk of complications. They can be frightening for parents. UK guidelines advise against the use of antipyretic drugs to prevent febrile seizure recurrence while being mindful of parental sensitivities.

Aim: This systematised literature review aimed to appraise the global body of evidence in relation to current guidelines on using conventional antipyretics for the prevention of febrile seizures and explore factors that influence their management.

Method: A research question was developed using the PICO (population/participant(s); intervention(s); comparison/control; outcome) framework and two databases were searched for primary research, and abstracts were screened for relevance.

Results: Thirty-four articles were identified, or which three were relevant to the research aim. These were critically appraised using the Mixed Methods Appraisal Tool and five themes were identified.

Conclusion: One study found that paracetamol may prevent recurrent febrile seizures, one found a small reduction in febrile seizure recurrence when treated with an antipyretic and one found antipyretics ineffective at reducing febrile seizure recurrence. Similar contemporary studies conducted in the UK population may help to improve understanding of the factors influencing febrile seizure management and the effectiveness of antipyretics.