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Still Wary of Rectal Acetaminophen
Kevin C. Osterhoudt, MD;
Fred M. Henretig, MD
Arch Pediatr Adolesc Med. 2009;163(5):491.
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A meta-analysis by Goldstein and colleagues1 nicely summarized that rectal acetaminophen can reduce fever, and though it is not believed to alter the course of infectious illness, we can assume it provides symptomatic relief. However, we find their call for the American Academy of Pediatrics to revise their recommendations pertaining to rectal acetaminophen in children to be premature, and their suggestion for more studies "evaluating possible pharmacodynamic differences in toxic effects between oral and rectal acetaminophen" to be slightly misplaced.
We believe that the mechanisms of toxicity for orally and rectally administered acetaminophen to be similar but that the patients receiving these formulations are inherently different. Acetaminophen suppositories are typically reserved for vomiting calorie-deprived children, a group that has been proposed to potentially be at a higher risk of toxicity due to glutathione depletion. Prescribing patterns for rectal acetaminophen, and risk factors . . . [Full Text of this Article] AUTHOR INFORMATION
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Still Wary of Rectal Acetaminophen—Reply
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Arch Pediatr Adolesc Med. 2009;163(5):491-492.
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