Fever in Children

“My child has a fever. Does it mean antibiotics are needed?”

Short Answer:

“Fever ≠ Always Antibiotics “

A child with fever does not always need antibiotics. What matters most is the underlying cause of the fever and how well the child is otherwise doing. 

A fever is a rise in body temperature, usually 38°C or higher, and is most often caused by the body’s immune system responding to an infection. Fever is very common in children and, in many cases, is related to a viral illness.

The temperature reading is useful, but your child’s overall condition is equally important — how they breathe, drink, respond, and behave.

Common Causes

Viral infections (most common)

• Common cold
• Influenza (flu)
• Viral tonsillopharyngitis (Throat infection)
• Hand, foot and mouth disease
• Viral gastroenteritis

Bacterial infections

• Ear infection
• Throat infection (Streptococcal)
• Pneumonia
• Urinary tract infection
• Other less common bacterial illnesses

Other causes

• A short-lived fever after some vaccinations
• Inflammatory or other medical conditions that may require assessment

Because viral infections are the most common cause of fever in children, antibiotics are often not needed. Antibiotics are considered only when the doctor suspects a bacterial infection based on the history, examination, and sometimes investigations.

“Fever above 38°C — Is teething the cause?”

Teething may cause mild discomfort and a slight temperature rise, but it should not cause a significant fever (38°C or higher).

If your child has a true fever, especially with symptoms such as cough, runny nose, vomiting, diarrhoea, poor feeding, unusual sleepiness, or irritability, another cause should be considered.

What Parents Can Observe

• How the temperature was measured, the highest reading and how long the fever has lasted.
• Whether your child is alert, responsive and able to settle between temperature spikes.
• Fluid intake, feeding, urine output and signs of dehydration.
• Other symptoms such as cough, breathing difficulty, rash, vomiting, diarrhoea, pain or unusual drowsiness.

Supportive Care at Home

• Offer frequent fluids and continue breast or formula feeding for babies.
• Dress your child comfortably and allow rest; avoid cold baths or excessive wrapping.
• Use fever medicine only when appropriate for your child’s age and weight and according to professional or product guidance. Avoid giving aspirin to a child.
• Check your child regularly, including during the night if they remain unwell.

When to Arrange a Paediatric Appointment

• The fever persists (lasts > 3 days), repeatedly returns or your child is not improving as expected.
• Your child has persistent pain, poor feeding, reduced urine, repeated vomiting or a new rash.
• You are concerned about your child’s behaviour, energy level or ability to recover between fever episodes.
• Your child has a long-term medical condition or reduced immunity.

What to Expect During the Consultation

The paediatrician may review the fever pattern, vaccination and medical history, hydration and associated symptoms. Examination may include the ears, throat, chest, abdomen and skin. Urine, swab, blood or other tests are considered only when the history and examination suggest they are needed.