Acetylcysteine treatment for non-acetaminophen-induced acute liver failure.
OBJECTIVE
To evaluate the effectiveness of intravenous acetylcysteine in the treatment of non-acetaminophen-induced acute liver failure (ALF).


METHODS
A search of MEDLINE (1966-March 2003), International Pharmaceutical Abstracts (1970-2003), and Cochrane Library (2003, issue 3) databases was conducted, using the search terms acetylcysteine, non-acetaminophen-induced hepatic failure, liver failure, intravenous, and treatment.


RESULTS
All of the studies found were small and do not provide conclusive evidence that acetylcysteine benefits this subgroup of patients. Microvascular regional benefits were seen, but clinical outcomes have not been studied.


CONCLUSIONS
Intravenous acetylcysteine should not be used routinely for treatment of non-acetaminophen-induced ALF. Further large-scale studies are needed to evaluate clinical outcomes.
Sklar
Grant E
GE
Department of Pharmacy, National University of Department of Pharmacy, and National University Hospital, Singapore. phages@nus.edu.sg
Subramaniam
Malar
M
D000111:Acetylcysteine / Q000008:administration & dosage / Q000627:therapeutic use*; D016166:Free Radical Scavengers / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007275:Injections, Intravenous; D017114:Liver Failure, Acute / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D016896:Treatment Outcome
D016166:Free Radical Scavengers; D000111:Acetylcysteine