Evaluation of occult acetaminophen hepatotoxicity in hospitalized childrenreceiving acetaminophen

The safety of repeated doses of acetaminophen in ill children with the pote ntial of reduced glutathione stores has been questioned. This study measure d hepatic transaminases in children and adolescents (n=100) who received gr eater than or equal to6 therapeutic doses of acetaminophen over a 48-hour p eriod of hospitalization. Acetaminophen-protein adducts were measured in a cohort of subjects with hepatic transaminase elevation (n=8) and in those ( n=10) receiving concurrent drug therapy with agents that induce the cytochr ome P450 enzymes involved in acetanlinophen metabolism. Acetaminophen-prote in adducts were not detected in this cohort of 18 subjects. Based on this P ilot study the routine use of acetaminophen at therapeutic doses in ill, ho spitalized children and adolescents appears safe.