Does lowering a fever >101°F in children improve clinical outcomes?

Nonpharmacologic measures also lower fever
A Cochrane review showed that cool water sponging caused fever reduction similar to antipyretics at 1 hour; sponging combined with ibuprofen reduced the proportion of patients still febrile at 1 hour. Common side effects of sponging included goose pimples and shivering. The antipyretic effect didn’t last beyond a few hours.¹⁰

Recommendations

Concerning treatment of fever, Nelson’s Pediatrics states, “Fever with temperatures less than 39°C (102.2°F) in healthy children generally does not require treatment. As temperatures become higher, patients tend to become more uncomfortable and administration of antipyretics often makes patients feel better. Other than providing symptomatic relief, antipyretic therapy does not change the course of infectious diseases. Antipyretic therapy is beneficial in high-risk patients who have chronic cardiopulmonary diseases, metabolic disorders, or neurologic diseases and in those who are at risk for febrile seizures. Hyperpyrexia (>41°C [105.8°F]) indicates greater risk for severe infection and should always be treated with antipyretics.”¹¹

Acknowledgement
The opinions and assertions contained herein are the private views of the authors and not to be construed as official, or as reflecting the views of the United States Air Force Medical Service or the US Air Force at large.