A Cochrane review (abstract , review [Abstract]) included 7 studies with a total of 467 patients. One small trial (n = 30), comparing physical methods with drug placebo, did not demonstrate a difference in the proportion of children without fever by one hour after treatment in a comparison between physical methods alone and drug placebo. In two studies, where all children received an antipyretic drug, physical methods resulted in a higher proportion of children without fever at one hour (n = 125; relative risk 11.76; 95% confidence interval 3.39 to 40.79). In a third study (n = 130), which only reported mean change in temperature, no difference was detected. Mild adverse events (shivering and goose pimples) were more common in the physical methods group (3 trials; relative risk 5.09; 95% confidence interval 1.56 to 16.60).
Comment: The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals).
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