A randomized, double-blind, placebo-controlled trial of paracetamol and ketoprofren lysine salt for pain control in children with pharyngotonsillitis cared by family pediatricians

A double-blind, randomized, placebo-controlled trial of a 12 mg/kg single dose of paracetamol paralleled by open-label ketoprofren lysine salt sachet 40 mg. Six to 12 years old children with diagnosis of pharyngo-tonsillitis and a Children's Sore Throat Pain (CSTP) Thermometer score > 120 mm were enrolled. Primary endpoint was the Sum of Pain Intensity Differences (SPID) of the CSTP Intensity scale by the child.97 children were equally randomized to paracetamol, placebo or ketoprofen. Paracetamol was significantly more effective than placebo in the SPID of children and parents (P < 0.05) but not in the SPID reported by investigators, 1 hour after drug administration. Global evaluation of efficacy showed a statistically significant advantage of paracetamol over placebo after 1 hour either for children, parents or investigators. Patients treated in open fashion with ketoprofen lysine salt, showed similar improvement in pain over time. All treatments were well-tolerated.A single oral dose of paracetamol or ketoprofen lysine salt are safe and effective analgesic treatments for children with sore throat in daily pediatric ambulatory care.Treatment of acute pain, particularly in pediatric population, should be a priority for clinicians. In the past, pain has been underestimated and sometimes undertreated in children, probably due to individual and social attitudes toward pain and the complexity of its assessment in children [1-3]. Nowadays, the importance of pain control in the pediatric population is widely recognized. However, there is still a lack of adequate clinical trials assessing the pharmacological effects of the oral analgesics commonly used in pediatric daily primary care [3,4].Paracetamol (acetaminophen) is currently one of the most popular and widely used analgesic and antipyretic in children for the symptomatic treatment of acute pain and fever. Differently from non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol does not produce gastrointestinal dam