Whenever our daughter has had a high fever and lethargy and we can't bring down the fever quickly and keep it down with tylonol, we have noticed that the triple dose does not really work, it drags on the process and we eventually have needed to give her the injectable solucortef, followed by the long acting injectable cortone which is good for 24 hrs, the next day then we go to the triple oral dose and see where we are from there. Whenever we have followed this regiment, we have had her bouce back quickly, whenever we have tried to put it off by just tripling the oral dose, we have ended up in the ER. That's just our experience though, and every kid is different. I do recommend getting comfortable with giving the shot, so that you don't hesitate because you are afraid of giving your child the shot. The solucortef injected is absorbed and in effect much quicker than the oral (within one-two hours you have maximum drug effect with the injection vs 4-6 hr with the oral.)