Letters
Treatments for paracetamol poisoning
Authors’ reply to Thomas and colleagues
BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i3461 (Published 28 June 2016) Cite this as: BMJ 2016;353:i3461
- Nicholas A Buckley, professor of clinical pharmacology and toxicology1 2 3,
- Andrew H Dawson, clinical toxicology specialist1 2 3,
- Geoffrey K Isbister, clinical toxicologist and emergency physician1 4
- 1NSW Poisons Information Centre, Sydney, NSW, Australia
- 2Sydney Medical School, University of Sydney, Sydney NSW 2006, Australia
- 3Department of Clinical Toxicology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
- 4Clinical Toxicology Research Group, University of Newcastle, Newcastle, NSW, Australia
- nicholas.buckley{at}sydney.edu.au
We agree with Thomas and colleagues that evidence to date has shown the updated guidance on acetylcysteine to be an expensive strategy with no demonstrable net benefit: frequent adverse effects of acetylcysteine possibly outweigh the postulated small reduction in severe hepatotoxicity.1 2
Moreover, the change has generated conflicting advice on threshold doses for initiating treatment. Current …
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