Randomized controlled trial of the effect of regular paracetamol on influenza infection

Jefferies, Sarah; Braithwaite, Irene; Walker, Steven; Weatherall, Mark; Jennings, Lance; Luck, Michelle; Barrett, Kevin; Siebers, Robert; Blackmore, Timothy; Beasley, Richard; Perrin, Kyle

These findings raise questions about the antipyretic efficacy of paracetamol in influenza and other respiratory infections. There are no previous studies of paracetamol in proven influenza infection in adults or children. We have found two studies of paracetamol in adults with upper respiratory tract infections. One study reported a non-significant 0.43°C reduction in temperature with regular paracetamol compared with placebo in presumed nonbacterial upper respiratory tract infections. 30 The other study compared a single 1000-mg dose of paracetamol with placebo in acutely febrile adults with upper respiratory tract symptoms and reported a significant reduction in temperature of 1.08°C. 31 In summary, this study has found that regular administration of paracetamol had no effect on viral shedding, temperature, symptoms or illness duration in patients with PCR-confirmed influenza infection or influenza-like illness that were also treated with oseltamivir. It is a priority to undertake further studies to ascertain the risk-benefit profile of the routine use of paracetamol alone in the treatment of presumed or PCR-confirmed influenza infection in otherwise healthy adults in the community.