Age-related patterns in paediatric paracetamol poisoning: a retrospective cohort study, 2015-2025
Abstract
Introduction: Paracetamol poisoning is a common cause of paediatric drug toxicity, but contemporary data on incidence trends, management, and predictors of toxicity remain limited. This study will evaluate incidence trends, clinical features, management, and dose-concentration relationships in paediatric patients with paracetamol poisoning.
Methods: Retrospective cohort study of patients aged ≤16 years evaluated at a tertiary hospital (2015-2025). Cases were identified through serum paracetamol measurements and classified by exposure pattern. Acetylcysteine administration was assessed according to TOXBASE-based institutional criteria. Spearman's correlation between reported dose (mg/kg) and serum concentration was analysed in acute overdoses.
Results: A total of 271 cases were included (114 aged ≤9 years; 157 aged 10-16 years). The incidence of identified cases of suspected paediatric paracetamol poisoning increased from 1.11 to 8.68 cases per 10,000 paediatric inhabitants between 2018 and 2025. Adolescents more frequently had intentional overdoses (96.8% versus 0%), higher reported doses (median 212.7 versus 150 mg/kg), and higher serum paracetamol concentrations (median 59.5 versus 30 mg/L [393.9 versus 198.6 µmol/L]) (P 0.001). Acetylcysteine was administered in 69.2% of cases and was considered inappropriate in 17% of treated patients, predominantly among younger children. Hepatotoxicity (ALT > 3 × ULN and/or bilirubin > 2 × ULN) occurred in 21.4%, and acute liver…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
Read the paper
Related studies
- Effect of dexamethasone as an analgesic adjuvant to multimodal pain treatment after total knee arthroplasty: randomised clinical trial
- Effect of a Postoperative Multimodal Opioid-Sparing Protocol vs Standard Opioid Prescribing on Postoperative Opioid Consumption After Knee or Shoulder Arthroscopy: A Randomized Clinical Trial
- Comparison of the Post-Caesarean Analgesic Effect of Adding Dexmedetomidine to Paracetamol and Ketorolac: A Randomized Clinical Trial
- A triple-blind randomized clinical trial of different associations between dexamethasone and non-steroids anti-inflammatories for preemptive action in third molar extractions
- An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients
- Oral paracetamol and/or ibuprofen for treating pain after soft tissue injuries: Single centre double-blind, randomised controlled clinical trial
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.