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Rectal Diclofenac Versus Rectal Paracetamol: Comparison of Antipyretic Effectiveness in Children
Mohammad Reza Sharif1, Mostafa Haji Rezaei2, Marzieh Aalinezhad3
1Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran.
Insights
Diclofenac suppositories demonstrated superior fever control compared to Paracetamol in children within the first hour. This study highlights Diclofenac as a potentially more effective antipyretic option for pediatric fever management.
Area of Science:
- Pediatric Medicine
- Pharmacology
- Clinical Trials
Background:
- Fever is a common pediatric complaint, with Paracetamol being the primary treatment despite potential toxicity.
- Diclofenac, a potent NSAID, is underutilized as an antipyretic in children.
- Rectal administration is a common route for antipyretics in pediatric care.
Purpose of the Study:
- To compare the antipyretic effectiveness of rectal Paracetamol versus rectal Diclofenac in children.
- To evaluate the efficacy of two common antipyretic agents administered rectally.
Main Methods:
- A double-blind, controlled clinical trial involving 80 children aged six months to six years.
- Participants received either rectal Paracetamol (15 mg/kg) or rectal Diclofenac (1 mg/kg).
- Rectal temperatures were measured pre-intervention and one hour post-intervention.
Main Results:
- Both groups showed an initial average temperature around 39.6-39.8°C.
- One hour post-intervention, the average temperature decreased to 38.39°C for Paracetamol and 38.95°C for Diclofenac (P=0.02).
- The average temperature reduction was significantly greater with Diclofenac (1.73°C) compared to Paracetamol (0.65°C) (P<0.001).
Conclusions:
- Rectal Diclofenac is more effective than rectal Paracetamol in reducing fever within the first hour of administration.
- Diclofenac shows promise as a potent antipyretic for pediatric use, warranting further investigation.
Background:
Fever is the most common complaint in pediatric medicine and its treatment is recommended in some situations. Paracetamol is the most common antipyretic drug, which has serious side effects such as toxicity along with its positive effects. Diclofenac is one of the strongest non-steroidal anti-inflammatory (NSAID) drugs, which has received little attention as an antipyretic drug.
Objectives:
This study was designed to compare the antipyretic effectiveness of the rectal form of Paracetamol and Diclofenac.
Patients And Methods:
This double-blind controlled clinical trial was conducted on 80 children aged six months to six years old. One group was treated with rectal Paracetamol suppositories at 15 mg/kg dose and the other group received Diclofenac at 1 mg/kg by rectal administration (n = 40). Rectal temperature was measured before and one hour after the intervention. Temperature changes in the two groups were compared.
Results:
The average rectal temperature in the Paracetamol group was 39.6 ± 1.13°C, and 39.82 ± 1.07°C in the Diclofenac group (P = 0.37). The average rectal temperature, one hour after the intervention, in the Paracetamol and the Diclofenac group was 38.39 ± 0.89°C and 38.95 ± 1.09°C, respectively (P = 0.02). Average temperature changes were 0.65 ± 0.17°C in the Paracetamol group and 1.73 ± 0.69°C in the Diclofenac group (P < 0.001).
Conclusions:
In the first one hour, Diclofenac suppository is able to control the fever more efficient than Paracetamol suppositories.
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