Title : The comparative effectiveness of antipyretics between oral paracetamol and intravenous metamizole In fever patient
Abstract:
Background: Fever is the most commonly encountered issue in hospitalized patients. The most frequently used antipyretics to address fever are paracetamol and metamizole. The choice of drug administration route is considered to potentially reduce the treatment period, and also affects the number of payments based on the Indonesian Case-Based Groups (INA-CBGs) by the Indonesian Health Insurance (BPJS Kesehatan).
Aims: This study aims to analyse the comparative effectiveness of antipyretics between oral paracetamol and intravenous metamizole in fever patients at the Inpatient Installation of RS Bala Keselamatan Bokor in September-October 2019.
Methods: An observational analytical design with Independent T-Test was used with inclusion and exclusion criteria. Inclusion criteria: fever patients (axillary temperature ≥ 37.5°C, aged > 18 years, willing to be a respondent, capable of active communication, and receiving therapy with oral paracetamol or intravenous metamizole. Exclusion criteria: aged < 18 years, hypersensitivity reactions to paracetamol or metamizole, patients with brain involvement diseases resulting in hypothalamic set-point disturbance.
Results: The study was conducted on 20 fever patients with the characteristics of 13 males (65.4%) and 7 females (34.6%). The mean initial temperature in the oral paracetamol group was 38.73°C and after 1 hour it became 36.53°C. In the intravenous metamizole group, the mean initial temperature was 38.66°C and after 1 hour it became 36.56°C. The temperature decrease after 15 minutes in the oral paracetamol group (1.45) was higher than the mean value in the intravenous metamizole group (0.42). However, after 30 minutes (Sig. 0.563 < 0.05) and 1 hour (Sig. 0.744 < 0.05), the temperature did not significantly decrease.
Conclusions: There was a significant difference (p < 0.05) in the temperature decrease in the oral paracetamol group compared to the intravenous metamizole group at the 15th minute.
