Intravenous vs oral acetaminophen: Which is more effective for treating fever in children?
Study compares the effects of IV vs oral dose in febrile children.
According to a new study published in the Indian Journal of Pediatrics, a single dose of intravenous (IV) acetaminophen is safe and effective in reducing fever and may be useful in patients who are unable to tolerate oral dose of acetaminophen and when rapid reduction of temperature is desirable.
Researchers evaluated the antipyretic effects in 400 children randomly assigned to receive either IV acetaminophen (15 mg/kg/dose; n=200) or oral acetaminophen (15 mg/kg/dose; n=200) over 6 hours.
Allergic reaction was reported in 7 (3.5%) of the patients in IV acetaminophen group whereas it was absent in oral acetaminophen group. Onset of constipation and dry mouth was reported in 8 (4%) patients in the IV acetaminophen group whereas it was absent in oral acetaminophen group. Requirement for additional dose was higher in IV acetaminophen group vs oral acetaminophen group (5% vs 3%; P=.307). Reduction in temperature was significantly high (weighted sum of temperature differences through 180 minutes) in IV acetaminophen group compared with oral acetaminophen group (P<.004).
This study concludes that faster reduction of temperature with IV acetaminophen may be considered superior in children, specifically with some paediatric ailments such as febrile seizure, febrile encephalopathy, and high fever with feed refusal where it is essential to prevent a scary convulsive attack and alarming metabolic compromise.
(Roy S, Simalti AK. Indian J Pediatr. 2017 Sep 9. doi: 10.1007/s12098-017-2457-3).