The efficacy of
antipyretics for preventing
febrile seizure recurrence has been reported by a recent study, and the results might overturn previous evidence. We systematically reviewed the efficacy of
antipyretics in the prevention of
febrile seizure recurrence in children focused on the timing of its administration. We searched the Medline, Embase, and Cochrane Central Register of Controlled Trials databases for randomized and quasi-randomized trials and prospective non-randomized studies of aged up to 60 months, diagnosed with
febrile seizure, who were treated with
antipyretics. Data were extracted from eight studies. Only one study reported that
antipyretics prevented the recurrence of
febrile seizures within the same
fever episode (9.1% in the
acetaminophen group vs. 23.5% in the control group, p < 0.01). Four studies found no evidence for the efficacy of
antipyretics in preventing
febrile seizure recurrence in distant
fever episodes (odds ratio, 0.92; 95% confidence interval, 0.57-1.48, for two randomized controlled studies).Conclusion: This review provides very limited support for the use of
antipyretics in preventing
febrile seizure recurrence within the same
fever episode and no evidence for its use in distant
fever episodes. New studies are required to evaluate this topic further and determine whether the effectiveness of
antipyretics is based on intervention timing. What is Known: • Reviews of prophylactic
drug management among
febrile seizure children found that
antipyretics had no significant benefits. • Recent data suggest that
antipyretics are effective in preventing
febrile seizures. What is New: • Weak evidence suggests a possible role in preventing
febrile seizure recurrence within the same
fever episode. • There is clearly no role for
antipyretic prophylaxis in preventing
febrile seizures during distant
fever episodes.