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Acetaminophen Does Not Improve Survival in Adults With Sepsis

Intravenous acetaminophen is safe, but does not improve number of days alive and free of organ support

By Elana Gotkine HealthDay Reporter

MONDAY, May 20, 2024 (HealthDay News) — For adults with sepsis, intravenous acetaminophen is safe but does not significantly improve the number of days alive and free of organ support, according to a study published online May 19 in the Journal of the American Medical Association to coincide with the American Thoracic Society 2024 International Conference, held from May 17 to 22 in San Diego.

Lorraine B. Ware, M.D., from the Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues examined whether acetaminophen increases days alive and free of organ dysfunction in sepsis in a phase 2b randomized clinical trial. Adults with sepsis and respiratory or circulatory organ dysfunction were enrolled in the emergency department or intensive care unit of 40 academic hospitals and were randomly assigned to 1 g acetaminophen intravenously every six hours or placebo for five days (227 and 220 patients, respectively).

The researchers found that acetaminophen was safe, with no difference noted between the treatment arms in terms of liver enzymes, hypotension, or fluid balance. There was no meaningful difference seen for acetaminophen versus placebo in days alive and free of organ support to day 28 (20.2 versus 19.6 days). In the acetaminophen arm, total, respiratory, and coagulation Sequential Organ Failure Assessment scores were significantly lower on days 2 through 4, as was the rate of development of acute respiratory distress syndrome within seven days.

“We hope that these findings will underscore the potential therapeutic value of using a biomarker to help successfully find a treatment that will work when patients need it the most,” senior author Michael Matthay, M.D., from the University of California, San Francisco, said in a statement.

Several authors disclosed ties to the biopharmaceutical industry.

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