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Comparison of Ibuprofen and Paracetamol for Fever Management in Sepsis and Septic Shock: A Randomized Controlled Trial

Safa Dönmez, Alp Şener, Nurullah İshak Işık, I. Akbas, Reyhan İrem Mutlu, V. Siber, Mehmet Yılmaz, H. Oguztürk

Eurasian Journal of Emergency Medicine, 2025

113 participants · 1 citation

Abstract

Aim: The aim of this study was to compare the efficacy of ibuprofen and paracetamol in fever management in patients with sepsis and septic shock and to evaluate their effects on body temperature and treatment outcomes. Materials and Methods: This randomized, parallel-controlled, double-blind study was conducted at Ankara Bilkent City Hospital. Patients aged 18 years and older diagnosed with sepsis or septic shock and presenting with a fever of ≥38.3 °C were randomly assigned to receive either intravenous ibuprofen (400 mg) or paracetamol (1 g). Body temperature was measured before treatment and at 30, 60, and 120 minutes after treatment. The primary outcomes were changes in body temperature and the proportion of patients achieving a body temperature 0.05). The most common source of infection was pulmonary, followed by urinary system infections. No significant difference in the distribution of infection sources was identified between the groups (p>0.05). Conclusion: Although a significant effect favoring ibuprofen was observed at 30 minutes, both ibuprofen and paracetamol effectively reduced fever in patients with sepsis and septic shock, with no significant difference in efficacy between the two drugs over time.

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 113 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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