Rectal-Axillary Temperature Difference in Febrile and Afebrile Infants and Children

Anagnostakis, D; Matsaniotis, N.; Grafakos, Stelios; Sarafidou, E.

doi:10.1177/000992289303200503

Cited by 35 publications

(19 citation statements)

References 13 publications

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“…Our findings are in agreement with those of Vernon, et al [15] and Scolnik, et al [14], but different from those of Leary et al [13]. These differences may be attributed to the fact that in Leary's study, all outcome measurements were based on axillary temperatures, the reliability of which is uncertain [16]. …”

Section: Discussionsupporting

confidence: 85%

Equal antipyretic effectiveness of oral and rectal acetaminophen: a randomized controlled trial [ISRCTN11886401]

Nabulsi¹,

Tamim²,

Sabra³

et al. 2005

BMC Pediatr

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BackgroundThe antipyretic effectiveness of rectal versus oral acetaminophen is not well established. This study is designed to compare the antipyretic effectiveness of two rectal acetaminophen doses (15 mg/kg) and (35 mg/kg), to the standard oral dose of 15 mg/kg.MethodsThis is a randomized, double-dummy, double-blind study of 51 febrile children, receiving one of three regimens of a single acetaminophen dose: 15 mg/kg orally, 15 mg/kg rectally, or 35 mg/kg rectally. Rectal temperature was monitored at baseline and hourly for a total of six hours. The primary outcome of the study, time to maximum antipyresis, and the secondary outcome of time to temperature reduction by at least 1°C were analyzed by one-way ANOVA. Two-way ANOVA with repeated measures over time was used to compare the secondary outcome: change in temperature from baseline at times1, 2, 3, 4, 5, and 6 hours among the three groups. Intent-to-treat analysis was planned.ResultsNo significant differences were found among the three groups in the time to maximum antipyresis (overall mean = 3.6 hours; 95% CI: 3.2–4.0), time to fever reduction by 1°C or the mean hourly temperature from baseline to 6 hours following dose administration. Hypothermia (temperature < 36.5°C) occurred in 11(21.6%) subjects, with the highest proportion being in the rectal high-dose group.ConclusionStandard (15 mg/kg) oral, (15 mg/kg) rectal, and high-dose (35 mg/kg) rectal acetaminophen have similar antipyretic effectiveness.

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Section: Discussionsupporting

confidence: 85%

Equal antipyretic effectiveness of oral and rectal acetaminophen: a randomized controlled trial [ISRCTN11886401]

Nabulsi¹,

Tamim²,

Sabra³

et al. 2005

BMC Pediatr

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“…However, differences between axillary and rectal temperatures may be more important during the variations of body temperature. 34,35 This may also contribute to the observation of lower temperature in adults. Finally, the most striking observation was the very short duration of a high proportion of fever episodes during malaria attacks regardless of the age of the patients.…”

Section: Discussionmentioning

confidence: 93%

Plasmodium falciparum clinical malaria in Dielmo, a holoendemic area in Senegal: no influence of acquired immunity on initial symptomatology and severity of malaria attacks.

Rogier¹,

Ly²,

Tall³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. Six hundred eighty-nine Plasmodium falciparum malaria attacks were observed during a three-year period among 226 inhabitants of the village of Dielmo, Senegal, an area of high malaria transmission. Malaria attacks were defined as clinical episodes with fever (body temperature Ն 38.0ЊC) or reporting of fever or headache or vomiting, associated with a parasite:leukocyte ratio above an age-dependent pyrogenic threshold identified in this population. The symptom frequencies were tested against age, gender, and parasite density using a random-effect logistic regression model and the study of distinguishable clinical presentations was carried out by multi-correspondence analysis. There was little difference between the severity of symptoms during the initial course of attacks in young children and adults, and this severity was not correlated with the duration of the pathologic episode. It was not possible to distinguish objectively different malaria attack types according to the severity of clinical manifestations. In contrast, the duration of fever, symptoms, and parasite clearance were significantly longer among the youngest children than among the oldest children and adults. These findings suggest that of the two components of protective immunity, anti-parasite immunity and anti-toxic immunity, only the first would play a major role as age increases. They suggest also that the initial clinical presentation of malaria attacks is not predictive of the level of protective immunity.The main goal of the current malaria control strategies is to prevent malaria mortality by diagnosing and treating clinical manifestations of the disease as early as possible. 1 This depends not only on the availability of efficient health services but also on the knowledge and the attitude of the patients or of their parents and on their perception of the initial symptoms that influence their therapeutic approach at home. Although a number of studies have been published on the signs and symptoms of clinical malaria in endemic populations, almost all of these studies were conducted in hospitals or outpatient clinics. Few detailed data are available on the range of clinical manifestations of malaria at the community level, their relative frequency, and their value in diagnosing the disease and initiating treatment. Since access to health facilities is difficult for most rural populations of tropical Africa, a better knowledge of clinical malaria at the community level could help to develop simple rules that would be necessary for reducing malaria mortality in these populations.A better knowledge of the whole range of malaria morbidity would also determine whether different clinical forms of nonsevere malaria attacks exist. The distinction between forms of malaria attacks that differ in the severity of clinical expression could have implications for the evaluation of control methods. The assessment of the clinical efficiency of malaria drugs or vaccines could vary according to the clinical forms that have been chosen to evaluate them...

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“…21 However, they employed axillary temperature, which is not reliable. 24 In a study conducted by Keinanen et al, oral acetaminophen was reported to be more effective and its effect was observed faster. 25 Nonetheless, this study was not randomized and a low dose of 10 mg/kg acetaminophen was administered.…”

Section: Discussionmentioning

confidence: 98%

Comparação da eficácia de doses iguais de acetaminofeno retal e oral em crianças

Karbasi¹,

Modares-Mosadegh²,

Golestan³

2010

J. Pediatr. (Rio J.)

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Objective: To compare a dose of oral and rectal acetaminophen and to evaluate acceptability of rectal acetaminophen, since oral and rectal acetaminophen is widely used as an antipyretic agent in febrile children and the comparative effectiveness of these two preparations is not well established. Methods:In this prospective parallel group designed study, 60 children who presented to the emergency department or outpatient pediatric clinic at a tertiary hospital and aged from 6 months to 6 years with rectal temperature over 39 °C were enrolled. Patients were randomly assigned to two equal-sized groups. Group 1 received 15 mg/kg acetaminophen rectally and group 2 received the same dose orally. Temperature was recorded at baseline and 1 and 3 hours after drug administration. Results:In the first group, mean decrease in temperature, 1 and 3 hours after administration of acetaminophen was 1.07±0.16 (p < 0.001) and 1.74±0.25 °C (p < 0.001), respectively, and in the second group it was 1.98±0.19 (p < 0.001) and 1.70±0.14 °C (p < 0.001), respectively (p > 0.05). Conclusion:Rectal and oral acetaminophen preparations have equal antipyretic effectiveness in children. The rectal route proved to be as acceptable as the oral one among parents. J Pediatr (Rio J). 2010;86(3):228-232:Oral acetaminophen, rectal acetaminophen, fever.

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Rectal-Axillary Temperature Difference in Febrile and Afebrile Infants and Children

Cited by 35 publications

References 13 publications

Equal antipyretic effectiveness of oral and rectal acetaminophen: a randomized controlled trial [ISRCTN11886401]

Equal antipyretic effectiveness of oral and rectal acetaminophen: a randomized controlled trial [ISRCTN11886401]

Plasmodium falciparum clinical malaria in Dielmo, a holoendemic area in Senegal: no influence of acquired immunity on initial symptomatology and severity of malaria attacks.

Comparação da eficácia de doses iguais de acetaminofeno retal e oral em crianças

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