TY - JOUR
PY - 2024//
TI - An analysis of clinical outcomes of exploratory pediatric metformin ingestions reported to the Texas Poison Center Network from 2011 to 2021
JO - Hospital pharmacy
A1 - Varney, Shawn M.
A1 - Watkins, Sarah
A1 - Stuteville, Haylea
A1 - Winter, Mark L.
A1 - Gao, Han Tony
A1 - Martin, Thomas G.
A1 - Morrissey, Ryan P.
A1 - Snodgrass, Wayne R.
A1 - Roth, Brett A.
SP - 465
EP - 470
VL - 59
IS - 4
N2 - BACKGROUND: Poison centers develop triage threshold guidelines for pediatric metformin ingestions. Our network uses 1700 mg, or 85 mg/kg.
OBJECTIVE: To describe the dose, clinical course, and outcomes for inadvertent metformin ingestions in children 5 years old and younger reported to our statewide poison center network.
METHODS: We searched the poison center database 2011 to 2021 for metformin ingestions in patients 5 years and younger. Variables included age, sex, weight, dose, symptoms, outcome, and more. We used descriptive statistics with medians and interquartile ranges (IQR) for continuous variables.
RESULTS: Of 669 cases, exposures by age were 208 (31.1%) 1 to 2 years, and 275 (41.1%) 2 years. Weight was recorded in 342 (51.1%) (median 13.5 kg; IQR: 3.7 kg), and dose in 149 (22.3%) (median 500 mg; IQR: 500 mg). Milligram/kilogram values were available for 103 (15.4%) with median 42.4 mg/kg, IQR: 39 mg/kg. Most (647, 98.5%) exposures were unintentional. Most (445/669, 66.5%) were managed at a non-healthcare facility, while 204 (30.7%) were already at or referred to a healthcare facility. Of these 204 patients, 169 (82.8%) were evaluated and treated at the emergency department and discharged. Four (2%) were admitted to critical care, and 7 (3.4%) to the ward. Medical outcomes by effect were 5 (0.7%) minor, 2 (0.3%) moderate, 253 (37.8%) none, 292 (43.6%) not followed (minimal effects possible), and no major effects or deaths. Of 20 clinical occurrences reported, vomiting was most common (8, 1.2%).
CONCLUSION: Despite little recorded dosage information, pediatric metformin ingestions under 85 mg/kg had predominantly uneventful medical outcomes.
Language: en
LA - en SN - 0018-5787 UR - http://dx.doi.org/10.1177/00185787241230628 ID - ref1 ER -