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To evaluate the clinical efficacy of nimesulide vs paracetamol in the treatment of acute inflammatory disorders of the airways, 40 paediatric patients (aged 3 to 12 years) with acute viral infections of the lower respiratory tract not requiring systemic antibiotic therapy in the first 3 days of observation were studied. Patients were randomly divided into 2 homogeneous groups receiving either oral nimesulide 1.5 mg/kg/day 3 times daily or paracetamol 120 to 288mg (5 to 12ml) 3 times daily for 3 to 7 days. Standard laboratory tests and chest x-rays were obtained at the beginning and end of treatment, and body temperature, blood arterial pressure and heart rate were recorded regularly. The anti-inflammatory effects of the 2 drugs (based on normalisation of erythrocyte sedimentation rate, C-reactive protein values, and white blood cell counts) were evaluated and the overall duration of the disease was assessed. The results showed that nimesulide was more effective than paracetamol in normalising body temperature (p < 0.05) and in reducing the inflammatory indices (p < 0.05), and that patients in the nimesulide group required a shorter treatment period than patients in the paracetamol group. No abnormal changes in arterial blood pressure or blood and urine analyses were seen in either group, and the reduction in heart rate was similar in both groups.