Acetaminophen Benefits Questionable for Patients With Fever Due to Infection: Study

The findings of a new study suggest that giving acetaminophen to patients in intensive care units who are running fevers, likely due to infection, appears to provide little, if any, benefit. 

Researchers from Australia and New Zealand looked into whether the common practice of giving acetaminophen, a pain killer and fever reducer, helped reduce fever in patients in intensive care units (ICU) who suffered from infections. Their findings were published on Monday in the New England Journal of Medicine.

The study involved 700 ICU patients who had a fever and were suspected of having an infection. Some they gave one gram on intravenous acetaminophen while others they gave a placebo every six hours until the patient was discharged from ICU, their fever came down, they stopped antimicrobial therapy, or they died. The primary outcome they measured was days alive and free from the need for ICU treatment.

The researchers found that patients given acetaminophen were in ICU just as long, overall, as patients who were not given the medication. The patients also suffered a comparable number of deaths.

“Our findings suggest that acetaminophen has a modest clinical effect as an antipyretic in ICU patients with fever and probable infection but does not reduce ICU-free days in these patients,” the researchers concluded. “Early administration of acetaminophen to treat fever due to probably infection did not affect the number of ICU-free days.”

Acetaminophen Health Risks

Acetaminophen is the most commonly used analgesic painkiller in the world, and is generally believed to be a safe medication. However, use of the medication does carry potential health risks, raising concerns about the unnecessary use of the medication.

Tylenol and other acetaminophen products have been identified in recent years as a leading cause for liver injury in the United States, causing an estimated 50,000 emergency room visits each year, including 25,000 hospitalizations and over 450 deaths annually. In addition, use of the medication has been linked to a risk of dangerous skin reactions, like Stephens-Johnson Syndrome.

In recent years, efforts have been ramped up to bring the risk of acetaminophen overdoses to the public’s attention and to reduce the amount of liver injury cases linked to the popular analgesic, which is also found in other pain killers and a number of cold medications.

In 2011, Johnson & Johnson lowered the maximum recommended dosage on Tylenol and other acetaminophen-based products from 4,000 mg per day to 3,000 mg per day. However, studies suggest that there is a narrow margin between the recommended dose and the risk of potentially life-threatening liver failure, with 500mg of acetaminophen contained in each tablet of Extra Strength Tylenol.

A number of Tylenol lawsuits are now being pursued throughout the United States, alleging that the drug maker has withheld important safety information from the public for decades.

In the federal court system, the first Tylenol trial is expected to begin in June 2015, which may provide a gauge for how juries may respond to certain evidence and testimony that is likely to be repeated in dozens of other cases.