What are the recommended management strategies for adults with fever due to suspected viral infections?

Adults presenting with fever suspected to be caused by viral infections should primarily be managed with supportive care, as most viral fevers are self-limiting and do not require antibiotics. Management includes:

• Encouraging adequate fluid intake to prevent dehydration.
• Using antipyretic agents such as paracetamol or ibuprofen to relieve distress caused by fever, but not solely to reduce body temperature.
• Avoiding physical interventions like tepid sponging, which are not recommended.
• Monitoring for any signs of serious illness or complications that would warrant further investigation or hospital referral.
• Providing advice on when to seek further medical help, such as if the fever persists beyond 5 days, if the patient develops new symptoms like rash or neurological signs, or if there is worsening clinical condition.

Antibiotics should not be prescribed unless there is clinical suspicion of bacterial infection. Clinical assessment should focus on identifying any 'red' or 'amber' features indicating serious illness that may require investigations or hospital admission. If no serious features are present, patients can be managed at home with safety-netting advice. Overall, the approach is conservative, symptom-based, and focused on patient education and safety-netting.

This management strategy aligns with the principles outlined in the NICE guideline for fever in children, which, while focused on under 5s, reflects the general approach to viral fever management in primary care settings in the UK, emphasizing supportive care and cautious use of antibiotics.

¹