Objective: To assess the comparative efficacy of oral versus rectal paracetamol in reducing fever in a pediatric acute care setting.

Methods: 200 children with body temperature >39ºc were randomized to receive oral or rectal paracetamol, together with tepid sponging. Their body temperatures were measured at enrollment, after fever reduction protocol had been completed and at 30-minute and 60-minute intervals. General linear model was used to assess the effect of time and type of medication on fever reduction.

Results: Mean log [temperature] differed significantly between time intervals (F(1.275, 248.576) = 32.766, p<0.001) and the test of between subject effects showed that there was a significant effect of antipyretic types on mean body temperature of children at different time intervals (F(1,995) = 4.040, p<0.05).

Conclusion: Rectal paracetamol was shown to be more effective overall at lowering body temperature, especially at the termination of fever reduction protocol, and at 60 minutes.