Abstract
BACKGROUND: Acute pharmaceutical exposure in children can lead to severe health outcomes and contribute to the inefficient use of medical resources. OBJECTIVE: This study aimed to investigate the clinical characteristics and outcomes of children with acute pharmaceutical exposure to guide the development of preventive strategies and educational initiatives. METHODS: We analyzed real-world data from electronic medical records of children admitted to the emergency department of a pediatric hospital for acute pharmaceutical exposure between January 2019 and December 2023. Clinical data, including laboratory test results, interventions, and outcomes, were collected. We compared different exposure events and conducted logistic regression analysis to identify risk factors for hospitalization. RESULTS: A total of 653 children were included in the study. The most common drugs involved in exposure were vitamins (149/653, 22.8%), nonsteroidal anti-inflammatory drugs (92/653, 14.1%), and psychiatric drugs (74/653, 11.3%). In total, 74.3% (469/631) of patients with complete clinical manifestation data showed no symptoms after exposure, and 68.1% (445/653) of patients did not require specific therapy. Toxicology screening was performed for 11% (72/653) of the children, and 69.4% (50/72) of these tests were positive. Independent risk factors for hospitalization included multisystem involvement (odds ratio [OR] 4.575, 95% CI 1.709-12.251, P=.002), psychiatric drugs (OR 6.280, 95% CI 2.189-18.020, P=.001), and intentional poisoning (OR 12.892, 95% CI 2.222-74.796, P=.004). CONCLUSIONS: Children with acute pharmaceutical exposure exhibit diverse clinical characteristics and outcomes, with most requiring no specific treatment. However, immediate toxicology screening and clinical intervention are essential for those exhibiting rapidly developing or multisystem symptoms, as well as those with intentional exposure or exposure to known highly toxic substances. Future pediatric health care policies should emphasize safe storage practices and public education on the prevention of pharmaceutical exposure.