Paracetamol study
New Zealand doctors lead a ‘first-ever’ trial of the world’s most commonly administered medicine
A Health Research Council of New Zealand-funded study led by New Zealand intensive care doctors has shown, for the first time, that treating fever in ICU patients with paracetamol is safe.
The study, presented on the 5th of October at the European Society of Intensive Care Medicine Annual Scientific Meeting in Berlin and published in the world’s most prestigious medical journal, The New England Journal of Medicine, looks set to influence medical practice around the world and to stimulate further research into the effects of paracetamol, the world’s most commonly used medicine.
“The study was designed by a group of doctors, predominantly intensive care specialists, who were concerned that the very common clinical practice of using paracetamol to blunt the body’s natural response to a fever caused by infection might worsen patient outcomes”, said the lead researcher and Intensive Care Specialist, Dr Paul Young.
In fact, although the study showed that paracetamol was safe and well-tolerated in ICU patients with fever and infection, it only reduced body temperature by around a quarter of a degree and neither improved nor worsened patient outcomes.
“Paracetamol is the world’s most commonly administered medicine and has been around for more than 60 years. It is remarkable, that this is the first time that its safety and effectiveness when used to reduce fever has been evaluated in a clinical trial of critically ill patients”, said Dr Young.
In a surprising finding, the researchers observed that patients who survived spent less time in ICU if they were given paracetamol. On the other hand, the patients who died spent more time in ICU before death if they received paracetamol.
One interpretation of this observation is that using paracetamol speeds up recovery in survivors and delays death in patients who ultimately die.
“Although a brief course of paracetamol used to treat fever did not reduce the overall risk of death in this study, the study looks certain to prompt further studies designed to determine whether more prolonged courses of paracetamol can reduce the risk of death in patients requiring Intensive Care,” said Dr Young.
Dr Young, who is an Intensive Care Specialist at Wellington Hospital, enlisted the support of more than 2,500 doctors and nurses from 23 Intensive Care Units across Australia and New Zealand (including 11 New Zealand ICUs) to conduct this study. Dr Young praised the support of his colleagues and highlighted that the study would not have been possible without the support of the Medical Research Institute of New Zealand (MRINZ). The MRINZ is an independent research institute in Wellington that has a particular focus on research with the potential to lead to improvements in clinical management.
“The MRINZ coordinated the study in partnership with the George Institute for Global Health (Sydney, Australia), and provided us with the necessary support to conduct a world-class clinical trial. This trial shows that MRINZ has the capability to support NZ doctors who identify areas of uncertainty in their clinical practice, to design and conduct trials to ultimately improve patient care”, says Dr Young.
For further information, please contact:
Dr Paul Young
Capital and Coast District Health Board
Email: paul.young@ccdhb.org.nz
or
Dr Shay McGuinness
Auckland District Health Board
Email: ShayMc@adhb.govt.nz