Acetaminophen: No Help (or Harm) for Critically Ill Patients with Fever

Is treatment of fever with acetaminophen a good thing for critically ill patients? Is cooling patients to reduce oxygen consumption and physiologic stress beneficial, or is fever a protective response to infection? To address these questions, investigators randomized 690 febrile adults in intensive care units (ICUs) in Australia and New Zealand to receive either intravenous acetaminophen or placebo. All patients were treated with antibiotics for infection or presumed infection and continued on the study drug until resolution of fever, completion of antibiotic course, death, or discharge from the ICU.

Although mean daily peak temperatures were significantly lower in the acetaminophen group than in the placebo group, the difference was quite s…