ReviewEuropean journal of pediatrics2014
Paracetamol: a focus for the general pediatrician.
Review in European journal of pediatrics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Paracetamol (acetaminophen) or non-steroidal anti-inflammatory drugs, alone or combined, for pain relief in acute otitis media in children.The Cochrane database of systematic reviews · 2023Pooled it
- Analysis of Nurses' and Physicians' Attitudes, Knowledge, and Perceptions toward Fever in Children: A Systematic Review with Meta-Analysis.International journal of environmental research and public health · 2021Pooled it
- Paracetamol (acetaminophen) or non-steroidal anti-inflammatory drugs, alone or combined, for pain relief in acute otitis media in children.The Cochrane database of systematic reviews · 2016Pooled it
- Acute postoperative pain control in pediatric patients: a scoping review.Journal of Yeungnam medical science · 2026Article
- Understanding Childhood Fever: A Qualitative Study of Family Attitudes, Emotions, and Caregiving Practices.Children (Basel, Switzerland) · 2025Article
- Evaluation of Paracetamol Overdoses in the Pediatric Emergency Department.Turkish archives of pediatrics · 2025Article
- Fever and Pain in Italian Children: What Pediatricians Really Do.Life (Basel, Switzerland) · 2025Article
- Article
- Childhood fever: Parental paracetamol administration after consulting out-of-hours general practice.The European journal of general practice · 2020Article
- Sedation and analgesia in children with cerebral palsy: a narrative review.World journal of pediatrics : WJP · 2019Review
- Fever in Children: Pearls and Pitfalls.Children (Basel, Switzerland) · 2017Review
- Pharmacokinetics, pharmacodynamics and pharmacogenetics associated with nonsteroidal anti-inflammatory drugs and opioids in pediatric cancer patients.Expert opinion on drug metabolism & toxicology · 2017Review
- Acute pain management: acetaminophen and ibuprofen are often under-dosed.European journal of pediatrics · 2017Observational
- Immature mice are more susceptible than adult mice to acetaminophen-induced acute liver injury.Scientific reports · 2017Article
- Analgesic Drug Prescription Patterns on Five International Paediatric Wards.Paediatric drugs · 2016Observational
- Streptococcus salivarius by nasal spray for recurrent otitis: how good is the evidence?European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2016Article
- The protective effect of pomegranate juice in paracetamol-induced acute hepatotoxicity in rats.Turk pediatri arsivi · 2016Article
- Fever and Pain Management in Childhood: Healthcare Providers' and Parents' Adherence to Current Recommendations.International journal of environmental research and public health · 2016Article
- Recent Advances in Pediatric Use of Oral Paracetamol in Fever and Pain Management.Pain and therapy · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
unlabelledParacetamol (acetaminophen) is one of the most popular and widely used drugs for the treatment of pain and fever in children. This drug has multiple mechanisms of action, but its pharmacodynamic is still not well known. The central nervous system is the main site of action and it mirrors the paracetamol effect compartment. The recommended dosages and routes of administration should be different whether paracetamol is used for the treatment of pain or fever. For example, the rectal route, while being efficacious for the treatment of fever, should be avoided in pain management. Paracetamol is a safe drug, but some clinical conditions and concomitant drugs, which are frequent in clinical practice, may increase the risk of paracetamol toxicity. Therefore, it is important to optimize its administration to avoid overdoses and maximize its effect. The principal mediator of the paracetamol toxicity is the N-acetyl-p-benzo-quinone imine (NAPQI), a toxic product of the paracetamol metabolism, which could bind cysteine groups on proteins forming paracetamol-protein adduct in the liver.
conclusionAlthough frequently prescribed, the concept of "effect compartment concentration" and the possible co-factors that could cause toxicity at recommended doses are not familiar to all pediatricians and general practitioners. We reviewed the literature concerning paracetamol mechanisms of action, we highlighted some relevant pharmacodynamic concepts for clinical practice, and we summarized the possible risk factors for toxicity at therapeutic dosages.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.