Rectal Diclofenac versus High-Dose Rectal Acetaminophen in Children: a randomized clinical trial

Fever is the most common complaint among the children admitted to health care centers. The aim of this study was to compare the anti-pyretic effect of diclofenac and high dose acetaminophen suppository in 1 to 6 years old children.

This double-blind clinical trial study was performed on 1-6-year-old children hospitalized in 17th Shahrivar Teaching Hospital, Rasht, Iran. Children were divided into two groups of 45 using a block randomization design. The first group received a high dose of acetaminophen suppository at a dose of 30 mg/kg and the second group received a diclofenac suppository at a dose of 1 mg/kg. The rectal temperature of the patients was measured using a digital thermometer at the time of drug administration, and one and three hours after that.

90 children were studied in two groups of 45 each. Temperature changes in the diclofenac group were significantly greater than the acetaminophen group, so from zero to 3 hours after administering diclofenac, the temperature decreased to 1.76±0.95°C. This reduction was lower in acetaminophen group (1.26±0.49°C, P=0.019).

Both acetaminophen and diclofenac suppositories significantly reduced the rectal temperature. However, the effect of rectal diclofenac on reducing temperature is more than rectal acetaminophen.