High-dose aspirin for management of Kawasaki disease

Some centres use high-dose aspirin as an adjuvant anti-inflammatory drug in the very acute phase (when the patient is febrile), but this is no longer common practice. In theory, high-dose aspirin may be synergistic with intravenous immunoglobulin and systemic corticosteroids; however, there is no evidence that it reduces the risk of coronary artery aneurysm formationMcCrindle, 2017.

Various doses of aspirin have been used in febrile patients, ranging from 30 to 50 mg/kg/day, given in 4 divided doses over 24 hours. If used, high-dose aspirin is typically continued for 24 to 48 hours after the fever resolves.