Acetaminophen (paracetamol) in the management of burned children with fever

Acetaminophen (paracetamol 12 mg/kg p.o.) was administered on a total of 33 occasions to 12 children (13-36 months of age) during the first 60 h after burn injury covering 10-44 per cent of the body surface area (BSA). The drug was effective in lowering rectal temperature on most (80 per cent) occasions; failure to elicit a response was not restricted to particular patients or patterns of injury. There was no evidence of tachyphylaxis to the antipyretic effects of acetaminophen. The pattern of change in the rectal and toe temperature after acetaminophen suggested that it may be acting by either increasing heat loss or by lowering heat production, both of which are consistent with a reduction in thermoregulatory setpoint mediated by inhibition of prostaglandin synthetase.