JMIR Publications

ABSTRACT

Background:

Acute pharmaceutical exposure and the related acute poisoning events in children can lead to serious health consequences and contribute to the waste of valuable medical resources.

Objective:

This study aims to investigate the clinical characteristics and outcomes of children with acute pharmaceutical exposures to inform the future development and implementation of preventive and educational strategies.

Methods:

We used real-world data recorded in electronic medical records for children with acute pharmaceutical exposure who admitted to the emergency department of a pediatric hospital from January 2019 to December 2023. Clinical information such as laboratory test results, clinical interventions and outcomes were collected. Comparisons between different exposure events were performed, and logistic regression analysis was used to identify risk factors for hospitalization.

Results:

Totally, 653 eligible children were included. Vitamins (22.8%, 149/653), non-steroidal anti-inflammatory drugs (14.1%, 92/653) and psychiatric drugs (11.3%, 74/653) were the three most common drugs causing exposure events. 75.2% (491/653) of the children had no symptoms after exposure events, and 68.1% (445/653) did not need specific therapy. Among the children, 11.0% (72/653) underwent toxicology screening and 69.4% (50/72) of them had positive testing results. Additionally, multi-system symptoms (OR: 4.675, 95% CI[1.745, 12.526], p = .002), psychiatric drugs (OR: 6.363, 95% CI[2.226, 18.190], p = .001), and intentional poisoning (OR: 13.100, 95% CI [2.248, 76.345], p = .004) were independent risk factors for hospitalization.

Conclusions:

Children with acute pharmaceutical exposure showed significant different characteristics and outcomes, and most exposed children did not need special treatment. However, immediate toxicology screening and clinical interventions are required for children who exhibit rapidly developing symptoms or multi-system symptoms involved, as well as those with intentional exposure or with known highly toxic exposure. Future pediatric healthcare policies are still needed to strength the safe storage practices and public education on pharmaceutical exposure prevention.