Randomized controlled study of the antipyretic efficacy of oral paracetamol, intravenous paracetamol, and intramuscular diclofenac in patients presenting with fever to the emergency department

Figures & data

Figure 1 Patient flow and enrollment chart.

Abbreviations: IM, intramuscular; IV, intravenous.

Table 1 Baseline demographic and clinical characteristics of enrolled patients

Variables	IM diclofenac (n = 150)	Oral paracetamol (n = 145)	IV paracetamol (n = 139)	Total (n = 434)	P-value
Age (years)	35.5 ± 14.24	36.2 ± 15.35	36.4 ± 14.98	36.1 ± 15.81	0. 695
Gender
Male	150 (100.0%)	144 (99.3)	139 (100.0%)	433 (99.8%)	0. 881
Female	0.0 (0.0%)	1 (0.7%)	0.0 (0.0%)	1 (0.2%)
IV fluids
Yes	36 (24.0%)	28 (19.3%)	44 (31.7%)	108 (24.9%)	0. 054
No	114 (76.0%)	117 (80.7%)	95 (68.3%)	326 (75.1%)
Antibiotic
Yes	9 (6.0%)	15 (10.3%)	20 (14.4%)	44 (10.2%)	0. 064
No	141 (94.0%)	130 (89.7%)	119 (85.6%)	389 (89.8%)
Nationality
Indian	45 (30.0%)	60 (41.4%)	46 (33.1%)	151 (34.8%)	0. 238
Nepalese	68 (45.3%)	49 (33.8%)	51 (36.7%)	168 (38.7%)
Pakistani	10 (6.7%)	8 (5.5%)	16 (11.5%)	34 (7.8%)
Bangladeshi	12 (8.0%)	10 (6.9%)	9 (6.5%)	31 (7.1%)
Sri Lankan	11 (7.3%)	8 (5.5%)	9 (6.5%)	28 (6.5%)
Others	4 (2.7%)	10 (6.9%)	8 (5.8%)	22 (5.1%)

Abbreviations: IV, intravenous; IM, intramuscular.

Figure 2 Mean temperatures at different time points for the three treatment groups.

Abbreviation: IV, intravenous.

Table 2 Comparison of mean temperature at different time points between the three treatment groups

Time (minutes)	IM diclofenac			Oral paracetamol			IV paracetamol			P-value
	n	Mean	SD	n	Mean	SD	n	Mean	SD
0	150	39.27	0.438	145	39.28	0.473	139	39.38	0.527	0.112
30	150	38.88	0.421	145	39.04	0.526	139	38.92	0.463	0.009
60	150	38.28	0.394	145	38.59	0.487	139	38.37	0.424	<0.0001
90	143	37.84	0.407	142	38.21	0.542	137	38.03	0.443	<0.0001
120	112	37.55	0.387	118	38.00	0.436	118	37.80	0.436	<0.0001

Note: Number of patients, particularly at 90 and 120 minutes, are less because patients who had temperatures within the normal range recovered and were discharged from hospital.

Abbreviations: IV, intravenous; IM, intramuscular; SD, standard deviation.

Table 3 Between-treatment comparisons of mean change from baseline in temperatures at different time points

Time/temperature (minutes)	IM diclofenac Mean ± SD (95% CI)	Oral paracetamol Mean ± SD (95% CI)	IV paracetamol Mean ± SD (95% CI)	P-value
30	−0.39 ± 0.29 (−0.34, −1.5)	−0.45 ± 0.36 (−0.39, −1.7)	−0.23 ± 0.35 (−0.17, −2.5)	<0.0001
60	−0.99 ± 0.34 (−0.94, −2.1)	−0.69 ± 0.43 (−0.61, −1.7)	−1.01 ± 0.40 (−0.94, −2.2)	<0.0001
90	−1.44 ± 0.43 (−1.4, −2.5)	−1.08 ± 0.51 (−0.99, −2.2)	−1.35 ± 0.46 (−1.3, −3.1)	<0.0001
120	−1.81 ± 0.46 (−1.7, −2.9)	−1.35 ± 0.51 (−1.3, −2.5)	−1.63 ± 0.55 (−1.5, −4.1)	<0.0001

Note: Mean change from baseline = post baseline mean – baseline mean 95% CI for mean change from baseline.

Abbreviations: IV, intravenous; IM, intramuscular; SD, standard deviation; CI, confidence interval.