Sepsis is a life threatening syndrome in which a dysregulated host response to infection
leads to life-threatening organ dysfunction [
[1]
]. In-hospital mortality for patients with sepsis is about 10% [
[1]
]. Hyperthermia is a common symptom of sepsis, but septic patients with hypothermia
have higher mortality rates than patients with hyperthermia [
[2]
]. Thus, fever appears to have a protective role in patients with sepsis. In the Netherlands,
some patients with sepsis receive paracetamol in the ambulances, mostly for pain management
as fever is not an indication for administration of paracetamol in the Dutch Ambulance
Protocol [
[3]
]. As patients with higher temperatures have lower mortality rates, it seems counterintuitive
to administer antipyretic drugs.To read this article in full you will need to make a payment
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Reference list
- The third international consensus definitions for Sepsis and septic shock (Sepsis-3)consensus definitions for Sepsis and septic ShockConsensus definitions for Sepsis and septic shock.JAMA. 2016; 315: 801-810
- Fever is associated with reduced, hypothermia with increased mortality in septic patients: a meta-analysis of clinical trials.PLoS One. 2017; 12e0170152
- Landelijk Protocol Ambulancezorg (LPA).(Available from:)
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- Early antipyretic exposure does not increase mortality in patients with gram-negative severe sepsis: a retrospective cohort study.Intern Emerg Med. 2012; 7: 463-470
- Antipyretic therapy in febrile critically ill adults: a systematic review and meta-analysis.J Crit Care. 2013; 28: 303-310
- Acetaminophen for fever in critically ill patients with suspected infection.N Engl J Med. 2015; 373: 2215-2224
- Association of body temperature and antipyretic treatments with mortality of critically ill patients with and without sepsis: multi-centered prospective observational study.Critical care (London, England). 2012; 16: R33
- The effect of antipyretic therapy upon outcomes in critically ill patients: a randomized, prospective study.Surg Infect (Larchmt). 2005; 6: 369-375
- Antipyretic therapy in critically ill patients with sepsis: an interaction with body temperature.PloS one. 2015; 10e0121919
- Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial.Lancet Respir Med. 2018; 6: 40-50
- Study protocol for a multi-Centre, investigator-initiated, randomized controlled trial to compare the effects of prehospital antibiotic treatment for Sepsis patients with usual care after training emergency medical services (EMS) personnel in early recognition − the prehospital ANTibiotics against Sepsis (PHANTASi) trial.Acute Med. 2016; 15: 176-184
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Article info
Publication history
Published online: September 11, 2019
Accepted:
August 31,
2019
Received in revised form:
August 29,
2019
Received:
July 25,
2019
Identification
Copyright
© 2019 Published by Elsevier B.V. on behalf of European Federation of Internal Medicine.
