Background: Fever in acute stroke is associated with poor prognosis, but evidence-based recommendations on antipyretic therapy are lacking.
Methods: A nation-wide survey was carried out among all certified stoke units in Germany about principles and organization of antipyretic strategies.
Results: In all cases antipyretic treatment is the standard of care. The use of paracetamol is part of the first-line therapy in 94%. In cases of non-response, distinct heterogeneity of therapeutic methods and intensities becomes apparent leading potentially to insufficient antipyretic treatment.
Conclusion: So far, there is uncertainty about the optimal antipyretic treatment strategy after acute stroke. While current guidelines are not very explicit, efforts should be made to define a standardized, evidence-based antipyretic protocol to improve patient care, outcome on stroke units and comparability of therapeutic strategies.