The key finding
A 2025 systematic review analyzing how parents treat fever in children found that paracetamol (also known as acetaminophen or Tylenol) is the clear favorite, chosen by 64.3% of parents, while only 27.4% opted for ibuprofen. Among parents with children under five years old, the pattern was similar: 63.2% used paracetamol versus 29.8% using ibuprofen. Notably, about one in five parents (20.3%) alternated between the two medications. Parents most commonly gave these medicines in syrup form and frequently made dosing decisions themselves rather than following strict medical guidance.
What the study looked like
This systematic review examined quantitative studies published between January 2000 and March 2024, focusing on parents and caregivers managing fever in children aged 0 to 17 years. Researchers searched four major databases (MEDLINE, PubMed, SCOPUS, and CINAHL) and included only studies where parents managed fever at home, excluding hospital settings or situations where healthcare professionals directly supervised treatment. Two independent reviewers assessed the quality of included studies using standardized evaluation tools, and data were analyzed using specialized software to combine findings across multiple studies. The review specifically looked at community-based fever management, reflecting real-world parenting decisions rather than controlled medical environments.
Why researchers think this happened
The authors suggest that multiple factors drive parents’ medication preferences. Paracetamol’s dominance likely reflects its longer history of use and widespread perception as the “default” or safest option for children, particularly younger ones. Parents reported considering perceived efficacy—how well the medicine seemed to work in past experiences—alongside safety profiles when making choices. The age and weight of the child influenced decisions, as did practical considerations like ease of administration (hence the preference for liquid syrups over tablets). Healthcare provider recommendations played a significant role, suggesting that medical advice shapes home practices. The pattern of alternating medications indicates that some parents employ a strategy of switching between drugs, possibly believing this provides better fever control or reduces risks associated with any single medication.
How to read this carefully
This review synthesizes parental behavior patterns but doesn’t establish that one medication is superior to the other for fever management. The study examined what parents choose to do, not what medical evidence recommends as optimal. Important limitations include the fact that this is observational data reflecting parental preferences and self-reported practices, which may not align with medical guidelines. The finding that parents often determine dosages themselves raises questions about accuracy and safety, since incorrect dosing is a real concern with both medications. The review doesn’t tell us about outcomes—whether children recovered faster or experienced fewer side effects with either medication. Geographic and cultural factors may also influence these patterns in ways the analysis couldn’t fully capture.
What this means for everyday life
If you’re a parent managing a child’s fever, this research highlights that you’re not alone in facing these decisions—and that many parents make medication choices based on a mix of past experience, perceived safety, and convenience. The findings suggest it might be worth having an explicit conversation with your pediatrician about which medication suits your child’s specific situation, proper dosing based on weight rather than age alone, and when alternating medications might or might not make sense. The prevalence of parent-determined dosing in the data points to a potential gap: many caregivers may benefit from clearer, more accessible guidance on measuring and administering these common medications. Given that one in five parents alternates between drugs, it’s worth asking your healthcare provider whether this strategy is appropriate for your child, as medical recommendations on alternating have evolved and vary by region.