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Evidence for physical measures is now redundant as it mostly pertains to tepid sponging,4 which is no longer recommended.5 Paracetamol and ibuprofen have both been shown to be superior to placebo6 7 8 and ibuprofen superior to paracetamol9 for the relief of fever. Given that the drugs have different mechanisms of action10 it is possible that they are more effective together than when used alone, but the evidence to date is sparse and conflicting. Five published trials11 12 13 14 15 mostly tested the effects of single doses at selected time points (which can arbitrarily advantage one drug because of the difference in times to maximum effect16), were largely done in secondary care, and reached conflicting conclusions.

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