Acetaminophen: acute overdose toxicity in children

The use of acetaminophen in young children has increased, in part due to concerns over the association of Reye's syndrome with aspirin. Accidental ingestion of acetaminophen in this age group has also increased, and treatment of overdose in children has been controversial. Recommendations for treatment of adolescents and young children are presented, based on the acetaminophen nomogram. It is recommended that children in the highest risk group (above the upper nomogram line) be treated with N-acetylcysteine, even though treatment may be unnecessary in many.