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Associations between paracetamol administration and delayed intravenous antibiotic administration among patients with

Sasinan Senangkhanikorn1, Nattaya Morapun2, Askas Samansee3

  • 1Faculty of Medicine, Division of Internal Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.

Journal of Hospital Medicine
|May 12, 2026
PubMed
Abstract

Insights

Paracetamol use before sepsis alerts did not delay antibiotic treatment or alter temperature changes in hospitalized patients. This finding is crucial for understanding sepsis management and fever treatment protocols.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Clinical Pharmacology

Background:

  • Timely antibiotic administration is vital for sepsis outcomes, but delays frequently occur.
  • Fever is a common sepsis symptom often managed with paracetamol, potentially masking sepsis and delaying treatment.

Purpose of the Study:

  • To investigate the association between paracetamol administration and delayed antibiotic treatment in hospitalized sepsis patients.
  • To evaluate paracetamol's impact on temperature trajectories in sepsis.

Main Methods:

  • Retrospective analysis of a prospectively collected sepsis registry at Songklanagarind Hospital, Thailand.
  • Included adult patients (≥15 years) with suspected sepsis (high NEWS score) from March 2023 to March 2024.
  • Assessed paracetamol use within 8 hours before sepsis trigger and its association with ≥180 min delay to antibiotic administration using logistic regression.

Main Results:

  • Of 1634 sepsis events, 12.5% had prior paracetamol use.
  • Paracetamol was not significantly associated with delayed antibiotic administration (aOR 1.29, p = .12).
  • No significant effect on temperature trajectories was observed; however, temperature-mortality association differed between paracetamol users and non-users.

Conclusions:

  • Paracetamol administration prior to a sepsis alert was not linked to delayed antibiotic treatment in this cohort.
  • Paracetamol did not significantly alter temperature changes in sepsis patients.
  • Further research is needed on the complex relationship between antipyretics, temperature, and mortality in sepsis.

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