Nimesulide effective in acute fever management in adults: JAPI

AUF is one of the common causes of patients seeking healthcare in India. AUF or acute febrile illness (AFI) refers to the fevers not extending beyond a fortnight and is characterized by a lack of localizable or organ-specific clinical features. The unspecific sign and symptoms, along with a lack of accurate diagnostic methods, pose a challenge to the health workers.4 The AUFs which have a duration of illness longer than three weeks are considered as PUO. The empirical treatment for AUF must be broad enough to avoid untimely mortality.5

Fever management includes antipyretic for symptomatic relief and empiric or specific therapeutic arsenal. Pharmacological methods of antipyresis include the administration of antipyretic drugs. Antipyretic drugs reduce fever primarily by inhibiting the formation of prostaglandin E2 (PGE2) in the brain. The physicalmethods of antipyresis include sponging with cold water or alcohol, application of ice packs and cooling fans along with sponging. The effect of fever may include metabolic effects such as increased heart rate and respiration, which can pose a challenge, especially in the elderly. Antipyretics may improve the accompanying responses and reduce the discomfort.Several antipyretic drugs, like Aspirin, Paracetamol, Nimesulide, Ibuprofen, Mefenamic Acid etc., are available and have been used for the management of fever for a long time.

Various clinical trials have established anti-inflammatory and antipyretic properties of Nimesulide in a controlled setting, however, the fever management in real-world settings is quite different.So, researchers aimed to assess the effectiveness of Nimesulide in acute fever management in real-world clinical practice.

For the study design, A retrospective, multicenter study was conducted on electronic medical records (EMR) of 302 patients visiting out-patient departments at three centers between Jan 2016 and Jan 2020 and were prescribed Nimesulide for acute fever. The effectiveness of Nimesulide was analyzed as a change in fever from baseline to follow-up visit within 14 days and tolerability as the number of side effects captured post-Nimesulide ingestion.

Results highlighted some new facts.

• The provisional diagnosis at the baseline visit reported major complaints like fever, fever with abdominal pain, body-ache, cough and myalgia.
• The mean baseline body temperature was 103.2±1.5°F with a mean duration of 4.4±2.8 days significantly (p<0.0001) decreased to 99.7±1.8°F on the administration of Nimesulide.
• The liver and the renal profiles were found to be normal on records, and the side effects such as nausea and dyspepsia were reported only in 2% of patients.

"Nimesulide decreased the fever with comparable effect across the age groups 18-75 years. Overall, Nimesulide for fever management in adults with acute fever was found to be effective with rather good tolerability. The study outcomes provide the necessary real-world evidence to physicians to consider Nimesulide as an alternative drug of choice to symptomatically manage the acute fever when treating a patient in out-patient department along with other definitive treatments like antibiotics as needed."the team concluded.

For full article follow the link: https://www.japi.org/x2946484/effectiveness-of-nimesulide-in-acute-fever-management-in-adults-retrospective-electronic-medical-records-database-study-outcome-in-outpatient-department

Source: Journal Of The Association Of Physicians In India