Acute paracetamol poisoning in children: a retrospective study of 42 cases in Sfax General Pediatrics Service

Paracetamol is one of the best selling drugs in the world for its analgesic and antipyretic properties. However, before the commoditization of its use and accessibility without a prescription, it appears as innocuous and harmless molecule. The aim of this study was to evaluate the management of patients admitted to general pediatric ward Hedi Chaker Hospital Sfax acute paracetamol poisoning during a period of 6 years from 1 January 2009 until 31 December 2014. A retrospective study has yielded information on 42 patients admitted for acute paracetamol poisoning using a questionnaire involving demographics, clinical history and the support arrangements. The acute paracetamol poisoning accounted for 36% of all drug poisoning and has hit in 95% of children under 5 years with a male predominance (sex ratio 0.9). Self-medication (82%) was the leading cause of accidental poisoning (76%). Hepatic lesions were described in 90% of patients with only transaminase assays. Hepatotoxicity has not been evaluated by blood level paracetamol according to the validated nomograms (Prescott). Abusive treatment with N-acetylcysteine had been established in all patients without the need for dose adjustment of tools. These results show that high consumption of paracetamol and ignorance of its adverse effects promote the occurrence of accidental poisoning in Tunisia. This results in considerable need of upgrading treatment protocols of acute poisoning with this product.