Pyrogenic Cytokines Mediated Pathophysiology of Fever and Role of Mefenamic Acid in Pediatric Practice

While fever in most cases represents a normal physiological response to illness, many times it is a presenting sign of a more serious underlying condition. Hence, it is important to assess a child who may be suffering with a serious condition and may require treatment in terms of antipyretic agents. The use of antipyretic agents is usually guided by the degree of fever, and the discomfort caused by fever and associated pain. Paracetamol and, more recently, ibuprofen are the generally used over-the-counter drugs for antipyresis. However, of late, there is a trend of increased use of mefenamic acid as antipyretic. Mefenamic acid has shown better efficacy and tolerability as compared to the other nonsteroidal anti-inflammatory drugs (NSAIDs) in use. In this review, authors have assessed the existing literature on the role of mefenamic acid in pediatric fever. They have highlighted the role of mefenamic acid in pediatric febrile illness in terms of clinical uses, efficacy, comparison with other NSAIDs and its safety in pediatric patients. Its probable action in inflammatory fever and febrile seizure due to its inhibitory action on the NLRP3 inflammasome and potential antiviral actions in viral infections are also highlighted, respectively