Efficacy of Alternating Antipyretic Therapy According to the Administration Interval in Children Using Patient-Generated Health Data: A Retrospective Observational Study

Abstract Caregivers are often advised to use additional antipyretic agents if fever persists before the next dosing time. However, no consistent evidence or guidelines have been reported. This study was to evaluate appropriate time intervals for alternating antipyretic therapy based on the antipyretic effect and incidence of low body temperature using large-scale patient-generated health data. Participants were children and their caregivers, who used the Fever Coach mobile application between February 2015 and December 2019. One case was referred to as a single record for up to 72 h after the first antipyretic record. Of the total 138,117 cases, the mean age was 29.58 months, and the mean baseline temperature was 38.77°C. The reduction in body temperature from baseline was -0.33°C, -0.54°C, and -0.62°C in the 2-3 hours, 3-4 hours, and 4-5 hours interval groups, respectively (P<.001, effect size 0.041). Within 6 hours, the area under the temperature curve from baseline was -201.59 in the 2-3 hours interval, -165.62 in the 3-4 hours interval, and -164.32 in the 4-5 hours interval groups (P<.001, effect size 0.014). In this study using large-scale patient-generated health data, antipyretic effects were greatest at the 2-3 hours interval for alternating therapy. Digitalized patient-generated health data could be used as a proper reference for real-world health guidelines.