COMPARISON BETWEEN THE EFFECT OF COMBINED PARACETAMOL AND IBUPROFEN WITH PARACETAMOL ALONE IN THE TREATMENT OF FEVER IN CHILDREN

Background: Fever is one of the most common clinical conditions in children and a frequent cause of healthcare visits. Paracetamol and ibuprofen are widely used antipyretics, and recent interest has focused on the potential benefit of combined therapy due to their different mechanisms of action. Objectives: To assess the effectiveness of combined paracetamol and ibuprofen therapy compared with monotherapy in reducing fever in children. Methods: An unblinded randomized clinical trial was conducted in Mosul General Hospital, including febrile children aged 1–6 years. Participants were allocated into three groups: paracetamol, ibuprofen, and combined therapy. Body temperature was measured at baseline, 1, 3, and 4 hours after drug administration. Data were analyzed using appropriate statistical methods, and a p-value <0.05 was considered significant. Results: Paracetamol showed a more rapid reduction in temperature at 1 hour, while combined therapy demonstrated significantly greater effectiveness at 4 hours. The success rate of fever reduction was highest in the combined therapy group compared to monotherapy. No statistically significant difference was observed between paracetamol and ibuprofen alone. No serious adverse effects were reported. Conclusions: Combined paracetamol and ibuprofen therapy is more effective than monotherapy in reducing fever after 4 hours, while paracetamol alone provides faster initial relief. Combined therapy may be beneficial in selected cases but should be used under medical supervision.