Poisoning due to medication dosing errors in Spain

Abstract

Introduction: Dosage errors are a common mechanism of poisoning in childhood. The aim of this study was to analyze the characteristics and management of poisoning secondary to dosage errors in pediatric emergency departments (EDs) in Spain.

Methodology: Study based on a prospective register of poisonings documented in 58 Spanish EDs participating in the Toxicology Surveillance Observatory of the Spanish Society of Paediatric Emergency Medicine (SEUP) between 2008 and 2023.

Results: The register documented 3429 episodes of exposure to toxic substances, of which 289 (8.4%) were medication dosing errors, with a vast majority occurring in the home setting. Seventy-eight (27.0%) occurred in children aged less than 1 year (amounting to 37.9% of poisonings in this age group and 85.0% of poisonings in infants aged less than 3 mo). Overall, the most commonly involved medications were antipyretics/analgesics (35.6%, mainly paracetamol), with significant differences depending on patient age. Forty-nine of the patients (17.0%) were symptomatic, 118 (41.8%) underwent additional testing, 83 (28.7%) received treatment, and 115 (39.8%) were admitted to the ED observation unit or to hospital. All had favorable outcomes.

Conclusions: Medication dosing errors constitute an important mechanism of poisoning, especially in children aged less than 1 year, leading to a significant number of interventions in EDs. Preventive measures aimed at educating families to avoid these poisonings should be considered.

Keywords: Dosage error; Error de dosificación; Fármaco; Intoxicaciones; Medication; Poisoning.