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The remaining trials used a different dosage or treatment regimen with the same artemisinin-based rectal preparation as a comparator: Looareesuwan1995 [ 35], Looareesuwan2000 (unpublished), Than1998 (unpublished).
Prior to CT simulation and each day before the treatment, patients followed instructions with a brochure on proper bowel and rectal preparation with partially full bladder and an empty rectum.
Whereas Leary et al. found oral paracetamol to be superior to the rectal preparation in reducing the temperature of febrile children [ 13], both Vernon et al [ 15] and Scolnik et al [ 14] found no difference in the antipyretic responses of oral and rectal acetaminophen.
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Other routes of administration discussed are rectal preparations, nasal formulations, and intravenous infusions.
This review addresses the lack of any data directly comparing the therapeutic efficacy and safety of the different rectal preparations of artemisinin derivatives.
In the absence of sufficient pharmacokinetic information it cannot be assumed that all rectal preparations have the same efficacy or safety profile.
Rectal preparations have the advantage of being easy to administer in rural areas; therefore it is anticipated that rectal administration of an artemisinin derivative in remote settings might "buy time" by halting or slowing the progress of disease while a patient is being transported to a health-care facility equipped to provide definitive treatment.
Two rectal steroid preparations were compared, 5 mg betamethasone enema b.d.
In conclusion, oral and rectal acetaminophen preparations seem to have equal antipyretic effectiveness which is in line with earlier studies.
More recently, rectal microbicide preparations and oral TDF alone or in combination with emtricitabine have been evaluated in PrP (Marrazzo et al., 2015), opening a new era in the fight against HIV.
Parents, as well as physicians, use the standard dose (10 20 mg/kg) of oral and rectal acetaminophen preparations interchangeably to treat fever in children, assuming they have equal antipyretic effects.
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