Behandeling bij paracetamolintoxicatie kan korter

In the Netherlands, 80% of paracetamol poisoned patients is treated for 24 hours with 600 mg/kg body weight of acetylcysteine. In the SNAP regimen, 300 mg/kg acetylcysteine is dosed in 12 hours, with the option to extend the treatment. If paracetamol concentration < 10 mg/L, ALT < 100 U/L, and INR ≤ 1.3, acetylcysteine treatment can be discontinued. Seventy percent of patients treated with the SNAP regimen require only 12 hours of treatment. The SNAP regimen has fewer side effects and is as effective as the previous Dutch acetylcysteine regimen and the international 'Prescott 21-hour' protocol. Recently, two treatment guidelines (NVIC and toxicologie.org) have been revised to adopt the SNAP regimen. Apart from a reduction in side effects, implementing the SNAP regimen for the treatment of paracetamol poisoning in the Netherlands likely reduce hospital stay and healthcare costs.

Conflict of interest and financial support: ICMJE forms provided by the authors are available online along with the full text of this article.