What guidelines should I follow for the use of antipyretics in adults with fever?

Current guidelines for the use of antipyretics in adults presenting with fever are not explicitly detailed in the provided UK guideline excerpts, which focus primarily on children under 5 years. However, extrapolating from the principles outlined for children, antipyretics such as paracetamol or ibuprofen should be considered for use in adults who are distressed by fever rather than solely to reduce body temperature.

Specifically, antipyretics should not be used with the sole aim of lowering temperature but rather to alleviate discomfort associated with fever. The use of paracetamol or ibuprofen can be considered if the patient appears distressed, and treatment should continue only as long as distress persists. Alternating or combining these agents is generally not recommended unless distress continues or recurs before the next dose is due.

Physical methods such as tepid sponging are not recommended for fever management. Additionally, patients should be advised to maintain adequate hydration and avoid over-wrapping or underdressing.

For adults, clinical judgement should guide antipyretic use, focusing on symptom relief rather than temperature normalization alone.

Summary: Use paracetamol or ibuprofen in adults with fever if they are distressed, avoid using antipyretics solely to reduce temperature, do not combine or alternate routinely, and avoid physical cooling methods like tepid sponging. Supportive care including hydration and appropriate clothing is advised.

Note: These recommendations are adapted from NICE guidelines primarily addressing children but reflect general principles applicable to adults in UK practice.

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