Paracetamol Suppository Dosing for a 17kg Child with Fever
For a 17kg male child with fever, administer 250mg paracetamol suppository (approximately 15 mg/kg per dose) every 4-6 hours, not exceeding 4 doses in 24 hours (total daily maximum: 60-65 mg/kg/day or approximately 1000mg/day). 1, 2
Dosing Rationale
The optimal single dose of paracetamol for children is 10-15 mg/kg per dose, with the higher end of this range (15 mg/kg) demonstrating superior antipyretic and analgesic efficacy 1, 2. For a 17kg child:
- Single dose calculation: 15 mg/kg × 17kg = 255mg per dose (round to 250mg suppository)
- Dosing interval: Every 4-6 hours as needed 1, 2
- Maximum daily dose: 60-65 mg/kg/day (approximately 1020-1105mg/day for 17kg child) 1, 3
- Maximum number of doses: 4 doses per 24 hours 1
Route-Specific Considerations
Rectal suppositories have equal antipyretic efficacy to oral formulations but exhibit slower and more irregular absorption 1, 4. The rectal route at 15-20 mg/kg demonstrates equivalent fever reduction compared to oral administration and provides a practical alternative when oral intake is not feasible 4.
Practical Administration Guidelines
- Available suppository strengths: Use 250mg suppositories for this weight range
- Timing: Space doses at minimum 4-hour intervals 1
- Duration: Continue as needed for fever management, typically 48 hours or until fever resolves 5
- Documentation: Parents should carefully record all dose times to avoid inadvertently exceeding maximum recommended doses 5
Important Safety Considerations
Common pitfall: Many dosing schedules recommend inadequate amounts of paracetamol that fall below the therapeutic range 2. The traditional 10 mg/kg dosing may be suboptimal; 15 mg/kg per dose is preferred for adequate antipyretic effect 1, 3.
Monitoring: Ensure adequate fluid intake to prevent dehydration, as fever should be treated primarily for child comfort 6. Physical cooling methods (tepid sponging, cold bathing) are not recommended as they cause discomfort without proven benefit 6.
Alternative consideration: If fever persists or inadequate response occurs, ibuprofen (10 mg/kg per dose every 6-8 hours) may be considered as first-line therapy, as it demonstrates superior antipyretic efficacy for bacterial infections 7, 5. However, if using both medications, meticulous dose tracking is essential to prevent overdosing 5.