title: Effect of N-acetylcysteine on inflammation biomarkers in pediatric acute pyelonephritis: a randomized controlled trial.
abstract: BACKGROUND
  This study was designed to investigate the effect of N-acetylcysteine (NAC), as a potent and safe antioxidant, on inflammatory biomarkers of acute pyelonephritis in pediatric patients.
  
  
  METHODS
  Children (< 15 years old) admitted with a diagnosis of pyelonephritis were recruited in a randomized placebo-controlled trial. They were randomly allocated to 2 groups and recieved placebo or NAC effervescent tablets with daily dose based on their weight, for 5 days. The children were evaluated for serum procalcitonin level, leukocyte count, C-reactive protein (CRP), serum creatinine, and clinical symptoms on the 1st and the 5th days.
  
  
  RESULTS
  Seventy patients, 35 in each group, with a mean age of 5.54 ± 3.10 years completed the study. There was no significant difference between the two groups in the amount of changes in procalcitonin levels after 5 days (P = .90). Within-group analysis confirmed CRP reduction in both groups (P < .001); however, between-group analysis did not show significant difference in CRP reductions, either (P = .65). No significant differences were found between the two groups in the day of resolving pyuria (P = .46), day of resolving bacteriuria (P = .81), or reductions in leukocyte count (P = .64) and neutrophil count (P = .49).
  
  
  CONCLUSIONS
  A short period of NAC administration with the recommended doses could not lead to a significant decrease in inflammation biomarkers. Studies on higher doses and longer duration of NAC administration along with evaluation of the long-term effects of the intervention by tools such as renal scntigraphy are suggested.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Allameh
authors.forename: Abdollah
authors.initials: A
authors.lastname: Karimi
authors.forename: Seddigheh
authors.initials: S
authors.lastname: Rafiei Tabatabaei
authors.forename: Mostafa
authors.initials: M
authors.lastname: Sharifian
authors.affiliation: Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran. j.salamzadeh@sbmu.ac.ir.
authors.forename: Jamshid
authors.initials: J
authors.lastname: Salamzadeh
mesh_terms: D000111:Acetylcysteine / Q000627:therapeutic use*; D000208:Acute Disease; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D006801:Humans; D007249:Inflammation / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D011498:Protein Precursors / Q000097:blood; D011704:Pyelonephritis / Q000097:blood* / Q000150:complications / Q000188:drug therapy*
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D016166:Free Radical Scavengers; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D003404:Creatinine; D015740:Calcitonin Gene-Related Peptide; D000111:Acetylcysteine