Q: 8-year-old with a fever over 40°C for a week despite strep antibiotics. ER refused tests. Is prolonged use of fever reducers and cough medicine safe?
- Myeongchan Kim, MD
- 22 hours ago
- 3 min read
Medically reviewed by Sang Hyun Ahn, MD
Content edited by Myeongchan Kim, MD
This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
Question:
Thank you for your previous advice. We visited the emergency room, but I am still very concerned. My 8-year-old child was diagnosed with strep throat, and the hospital simply told us to take amoxicillin for 7 more days. They did not seem to care that my child has had a high fever (over 40.2°C) for over a week and has been taking fever reducers this entire time, and they just discharged us. The doctor listened to the lungs and said they sounded fine, but they refused to do a blood test or a chest X-ray. They just told us to continue taking the cough medicine and fever reducers.
Is it safe for an 8-year-old to take dextromethorphan, Tylenol, and ibuprofen for more than a week? We are currently giving fever reducers 4 to 5 times a day just to manage, and it doesn't seem like the fever will break soon. Also, while in the ER, they gave Tylenol and ibuprofen at the exact same time for the high fever. Is this okay? I thought they had to be alternated with a 2-hour gap.
Answer:
It is completely understandable that you are worried, especially after being discharged from the emergency room without thorough testing. A high fever lasting more than a week requires a more comprehensive clinical evaluation.
Current Clinical Concerns:
High fever (40.2°C) persisting for over 7 days.
No improvement despite ongoing antibiotic treatment for strep throat.
Basic diagnostic tests (blood tests, X-rays) were not performed.
Prolonged, heavy use of fever reducers.
Medication Guidelines & Answers:
Dextromethorphan: This active ingredient is generally safe for an 8-year-old, but taking it continuously for more than 7 days requires a doctor's re-evaluation.
Tylenol and Ibuprofen Given Simultaneously: While administering them at the exact same time is medically possible and sometimes done in hospital settings for severe, stubborn fevers, it is not the standard practice for general care (where alternating them with a gap is preferred).
Prolonged Fever Reducers: Extended daily use of these medications requires checking the child's kidney and liver function to ensure they are processing the medication safely.
Immediate Action Required:
Please have your child re-evaluated by a doctor within the next 24 hours. A persistent fever over 40°C that does not respond to strep antibiotics strongly suggests that there may be another underlying cause for the fever that needs to be identified.
Seek a Second Opinion: It is strongly recommended that you visit a different hospital or pediatrician as soon as possible.
Request Specific Tests: Ask for a complete blood count (CBC) and a chest X-ray.
Key Points to Emphasize: When you see the new doctor, clearly state: "The patient has a persistent fever over 7 days despite antibiotics," "We are requesting a complete blood count and chest X-ray," and "We are highly concerned about complications."
As you are navigating this healthcare system, remember that many hospitals allow you to request a "Patient Advocate" to help facilitate your care. If a medical provider refuses to run diagnostic tests after a week of 40°C fevers, you have the right to politely request that their refusal be documented in writing in the patient's chart. Please seek in-person medical attention right away.
For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.
