The Growing Impact of Pediatric Pharmaceutical Poisoning

Objective

To understand which medications, under which circumstances, are responsible for the noted increase in pediatric medication poisonings, resource use, and morbidity.

Study design

Patient records from 2001-2008 were obtained from the National Poison Data System of the American Association of Poison Control Centers for children aged ≤5 years evaluated in a health care facility following exposure to a potentially toxic dose of a pharmaceutical agent. Pharmaceutical agents were classified as over-the-counter or prescription and by functional category. Exposures were classified as child self-ingested the medication or as therapeutic error. For the 8-year period, emergency visits, admissions, significant injuries, and trends in these events were calculated for each substance category.

Results

We evaluated 453 559 children for ingestion of a single pharmaceutical product. Child self-exposure was responsible for 95% of visits. Child self-exposure to prescription products dominated the health care impact with 248 023 of the visits (55%), 41 847 admissions (76%), and 18 191 significant injuries (71%). The greatest resource use and morbidity followed self-ingestion of prescription products, particularly opioids, sedative-hypnotics, and cardiovascular agents.

Conclusions

Prevention efforts have proved to be inadequate in the face of rising availability of prescription medications, particularly more dangerous medications.

AAPCC, American Association of Poison Control Centers, ARCOS, Automation of Reports and Consolidated Orders System, ED, Emergency department, OTC, Over-the-counter, NPDS, National Poison Data System