2026 Eastern States Conference

Title: Impact of bromocriptine on suspected neurogenic fever
Authors: Maeghan Biché, PharmD; Benjamin Wilkinson, PharmD, BCCCP; Haley Kavelak, PharmD, BCCCP; Julia Bold, PharmD
Objective: Audience members will be able to describe the impact of bromocriptine on fever in patients presenting with suspected neurogenic fever.
Self-Assessment Question: What patient population(s) may benefit most from bromocriptine use based on this study?
Background: Bromocriptine is hypothesized to have an antipyretic effect in patients with neurogenic fever, however the evidence is limited to small retrospective studies. This study aims to describe the impact of bromocriptine on neurogenic fever.
Methods: This retrospective chart review included adult patients admitted to the neurological intensive care unit (ICU) who received at least one dose of bromocriptine for suspected neurogenic fever between 6/1/2020 and 6/1/2025. The primary outcome was the change in maximum body temperature (Tmax) from the 24-hour period prior to bromocriptine administration (day 0) to the 48-to-72-hour period after initial administration (day 3). Secondary outcomes included change in Tmax from day 0 compared to 0 to 24 hours after administration (day 1) and 24 to 48 hours after administration (day 2), duration of fever, ICU length of stay (LOS), hospital LOS, and mortality 30 days after bromocriptine administration. Outcomes were analyzed by Mann-Whitney U test.
Results: A total of 75 patients were included in the analysis with a median age of 53 years. Administration of bromocriptine resulted in a significant decrease in temperature on day 3 (38.8 ºC vs 38.2 ºC, p < 0.001). The median dose of bromocriptine administered was 15mg on day 1, 30mg on day 2, and 40mg on day 3. Patients with a traumatic injury (n=22) had a greater reduction in fever compared to those with a non-traumatic injury at 72 hours (-0.8 ºC vs -0.5 ºC, p=0.002). The median duration of fever was 2 days. Hypotension occurred in 27 patients after administration, and 20 patients experienced nausea.
Conclusion: In patients with suspected neurogenic fever, bromocriptine may be an option for temperature reduction when added to other antipyretics. Patients with traumatic injury demonstrated a greater reduction in fever, suggesting greater efficacy in this population. Further investigation into dosing strategies is needed.