Antipyretic Effect of Parenteral Paracetamol (Propacetamol) in Pediatric Oncologic Patients: A Randomized Trial

Abstract

The antipyretic efficacy of propacetamol, an intravenous prodrug of paracetamol, was evaluated in two pediatric prospective randomized studies. In the first, we compared one standard intravenous dose of propacetamol (30 mg/kg) to one standard intravenous dose of acetyl-salicylic acid (ASA, 15 mg/kg) in 10 nononcologic patients with bacterial illnesses. In the second study, we compared two intravenous doses of propacetamol (30 mg/kg versus 15 mg/kg) in 24 oncologic patients with fever and neutropenia. No statistically significant differences in antipyretic efficacy were found between standard doses of propacetamol and ASA; even when half-doses of propacetamol (15 mg/kg) were used, good antipyretic efficacy was observed, which was not statistically different from that observed with the full dose. The use of propacetamol seems promising for patients (such as oncologic patients) who cannot receive enteral paracetamol formulas.

Key Words:

• acetaminophen
• fever
• neutropenia
• paracetamol
• prodrug