Accidental dextromethorphan ingestions in children less than 5 years old

The purpose of this study is to evaluate the clinical presentation of accidental dextromethorphan (DXM) ingestions in children <5 years old. Two consecutive years of poison center patient encounters were reviewed. Data including age, outcomes, amount of DXM ingested, co-ingestions, vital signs, clinical manifestations, hospital admissions, and mortality were abstracted. Data were analyzed using descriptive statistics.

A total of 304 cases were identified with a mean age of 28.2 months (72% were > or =23 months). All cases co-ingested other products of over-the-counter cough and cold medications (i.e., acetaminophen, pseudoephedrine, guaifenesin, ibuprofen, various H1 receptor antagonists, and very infrequently ethanol). The mean DXM dose ingested was 35.0 mg (2.64 mg/kg). Of the patients, 62 (20.4%) experienced lethargy as the sole neurological sign and no patient had any cardiovascular abnormalities. Only 1 (13-monthold) patient, who ingested 3.2 mg/kg and presented with lethargy, was hospitalized and subsequently discharged 14 hours later. No deaths were recorded.

As demonstrated in our patient population, accidental ingestions of DXM in the pediatric patient did well with supportive care alone and rarely required inpatient treatment.