We found that in septic patients, compared with the 36.5��C to 37.4��C subgroup, MAXICU 37.5��C to 38.4��C was associated with decreased mortality and MAXICU �� 38.5��C was not independently neither associated with mortality. By contrast, in non-septic patients, high fever (�� 39.5��C) was independently associated with mortality. We also found significant interactions between mortality and treatment with NSAIDs or acetaminophen only in septic patients.Limitations of this studyOur study had several limitations. First, because it was designed as an observational study without standardized protocols for antipyretic treatments, the findings can only show association and not causality. Thus, our results can only be viewed as useful for generating hypotheses.The methods of body temperature monitoring were not standardized.

Furthermore, the majority of the body temperatures was measured by axillary thermometers, although core temperature is less influenced by external factors and more accurately reflects temperature of the vital organs [21]. Additionally, it is possible that the sickest patients were more likely to have had invasive measurements of core temperature, resulting in relatively higher values. The proportion of methods of body temperature monitoring, however, used in septic patients was not significantly different from non-septic patients. Thus, any bias-related body temperature monitoring would similarly influence both cohorts. Nonetheless, our finding may be accentuated due to changes in circulation occurring during the progression of sepsis environmental temperature [22].

In this regard, our finding should be confirmed or refuted by further studies using core body temperature monitoring.Although the proportion of patients treated with pharmacological antipyretic treatments were similar in both septic and non-septic patients, NSAIDs were more frequently administered to non-septic patients, while acetaminophen was used more frequently for septic patients. Additionally, acetaminophen was less frequently administered in the present study than in other studies. Young et al. reported that acetaminophen was administered to 58% to 70% of septic patients [10], while only to about 20% in our patients. Physical cooling was applied more frequently in our population than reported elsewhere [10]. These facts may influence their association with mortality. Thus, we duly note that our findings Anacetrapib may not be applicable to other settings where antipyretic procedures are different. Additionally, we studied in only two countries and our findings may not be generalizable to other countries, especially those with different medical systems.We used delta body temperature after antipyretic treatments to compare the strength of each antipyretic effect.