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Still Wary of Rectal Acetaminophen—Reply
Lee H. Goldstein, MD;
Maya Berlin, BPharmSci;
Eran Kozer, MD;
Matitiyahu Berkovitch, MD
Arch Pediatr Adolesc Med. 2009;163(5):491-492.
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In reply
We thank Drs Ousterhoudt and Henretig for their comments. The American Academy of Pediatrics' recommendation to refrain from rectal acetaminophen was based on pharmacokinetic studies showing great variation of peak levels of acetaminophen administered rectally, often not achieving therapeutic levels, with longer time to peak concentrations.1 Our meta-analysis showed that pharmacodynamic variables, such as temperature reduction, were similar with rectal and oral administration.2
We do agree, of course, that as with any medication, in any form of administration, physicians should give sufficient instructions to caregivers as to the correct dosage and intervals between doses. Precautions should be taken with severely dehydrated children when administering both oral and rectal acetaminophen owing to higher chance of toxicity.
AUTHOR INFORMATION
Correspondence: Dr Goldstein, Clinical Pharmacology Service, Medicine C, Haemek Medical Center, Afula, Israel 18101 (goldstein_le@clalit.org.il).
Author Contributions: Study . . . [Full Text of this Article]
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Effectiveness of Oral vs Rectal Acetaminophen: A Meta-analysis
Lee Hilary Goldstein, Maya Berlin, Matitiahu Berkovitch, and Eran Kozer
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Still Wary of Rectal Acetaminophen
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Arch Pediatr Adolesc Med. 2009;163(5):491.
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