What is the best course of action for fever in an 8-year-old with chickenpox?

• A. Paracetamol 375 mg every 4-6 hours; maximum 4 doses per day
• B. Ibuprofen 200 mg every 6 hours
• C. Acetaminophen 500 mg every 6 hours
• D. Aspirin 300 mg every 4-6 hours

Answer: (A)

Fever in a child with chickenpox is best managed with a safe, effective antipyretic that is well-tolerated in viral illnesses. Paracetamol (acetaminophen) fits this role first-line because it reduces fever and discomfort with a favorable safety profile and a low risk of serious complications in viral infections.

The recommended approach uses a pediatric-appropriate dose given every 4–6 hours, up to a maximum of four doses in 24 hours. This schedule provides reliable fever control while staying within the daily safety limits. In contrast, aspirin is avoided in children with viral illnesses like chickenpox due to the risk of Reye’s syndrome, a serious condition that links aspirin use to sudden liver and brain injury. Ibuprofen, an NSAID, can be used if needed, but many guidelines favor paracetamol as the initial choice for fever and discomfort in this setting.