Comparative evaluation of the efficacy of intravenous paracetamol and ibuprofen on the treatment of tonsillopharyngitis with fever: A prospective, randomized controlled, double‐blind clinical trial
1Servergazi State Hospital, Emergency Service, Denizli, Turkey
2Department of Emergency Medicine, Medical Faculty, Pamukkale University, Denizli, Turkey
3Department of Emergency Medicine, Medical Faculty, Kafkas University, Kars, Turkey
4Department of Family Medicine, Medical Faculty, Pamukkale University, Denizli, Turkey
Keywords: Emergency department, fever, ibuprofen, intravenous, paracetamol, upper respiratory tract infections
OBJECTIVE: Tonsillopharyngitis is one of the constituents of upper respiratory tract infection (URTI). Fever is a URTI symptom requiring treatment due to the occurrence of discomfort and high fever-based complications. This study primarily sets out to observe and compare the efficacy of intravenous administration of paracetamol and ibuprofen drugs on fever in adult patients with tonsillopharyngitis.
METHODS: This study was performed in a prospective, randomized controlled, double-blind design. The study population was divided as Group 1 (treated with paracetamol) and as Group 2 (treated with ibuprofen). While the first group was treated with paracetamol as 1000 mg in 150 ml normal saline, the second group was treated with ibuprofen as 400 mg in 150 ml normal saline. The primary outcome was the decrease in fever at 15, 30, and 60 min, while the secondary outcome was the need for additional treatment after 60 min.
RESULTS: One hundred and eighty-five patients were included in the final analysis. The mean age of the paracetamol group (57.4% male) was 28.36 ± 9.6, whereas that of the ibuprofen group (54.9% male) was 27.45 ± 7.98. Fever was reduced significantly between 0 and 60 min in both groups (P ≤ 0.001 and P ≤ 0.001, respectively). Although the antipyretic effect of ibuprofen was more pronounced in the early period than that of paracetamol, no significant difference was noted between the two groups in terms of fever drop between 0 and 60 min (P = 0.350).
CONCLUSION: Although both drugs prove effective in controlling fever at the 60 min, stronger efficacy of ibuprofen in the first 15 min may enable rapid discharge from the emergency department.
The approval to our study was granted by PamukkaleUniversity Ethical Committee for Clinical Investigationswith the decision number 60116787020/75662(dated October 30, 2018 and numbered 2018/20).
Subjects were included in the study after giving their informed consent. The authors certify that they have obtained all appropriate patient consent forms. In the form the patients have given their consent for their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Study concept and design: A.Y. and G.O
Acquisition of data: G.O
Analysis and interpretation of data: A.Y., G.O. and R.S
Drafting of the manuscript: A.Y., G.O. and R.S
Critical revision of the manuscript for important intellectual content: A.Y. and G.O
Statistical analysis: R.S. and Y.K.C
Administrative, technical and material support: I.T., M.S., M.O., and U.C
Study supervision: A.Y.