To the Editor.—I have just finished reading the paper on "Oral Antipyretic Therapy" by R. W. Steele and associates in the March issue of the Journal (123:204-206, 1972) and have scrutinized the record of the evidence for the conclusion "that a combination of aspirin and acetaminophen is more effective in reducing fever in children than either drug used alone."
Would not it have been better for the group of children given aspirin and those given acetaminophen to have received twice as much as was actually given? Current opinion holds that these drugs are additive rather than synergistic. In the experiments recorded, the group of children who received aspirin plus acetaminophen actually received twice as much of the antipyretic drugs as did those of either of the so-called control groups. Therefore, the observed "more effective" results might have been due to the larger total dosage rather than to the combination