There is a need for a North American acetylcysteine regimen. The four North American clinical toxicology societies should commission an expert panel with the mandate to recommend a specific acetylcysteine dosing regimen for the treatment of paracetamol (acetaminophen) poisoning. The recent systematic review and meta-analysis, the lack of published data showing the advantage of the one-bag two-step regimen over the two-bag approach, and its unique hazard support a two-bag regimen.
MILTON TENENBEIN (2026) studied this question.