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Risk of toxicity from pediatric topical salicylate ingestions

Kate Arriola1, Lee Cantrell1,2

  • 1Department of Clinical Pharmacy, University of California, San Francisco, CA, USA.

Clinical Toxicology (Philadelphia, Pa.)
|November 27, 2020
PubMed

Insights

Pediatric topical salicylate ingestions rarely cause severe symptoms or require hospitalization, particularly non-liquid formulations. Healthcare facility evaluation for over one teaspoon of topical salicylate is generally low-risk for children.

Area of Science:

  • Toxicology
  • Pediatric Emergency Medicine
  • Clinical Toxicology

Background:

  • Poison control centers recommend healthcare facility management for pediatric ingestions of ≥1 teaspoon of topical salicylate analgesics.
  • This recommendation applies to both liquid and non-liquid (cream, ointment, gel) topical salicylate formulations.

Purpose of the Study:

  • To analyze the outcomes of pediatric patients younger than 6 years who ingested topical salicylates and were evaluated at a healthcare facility.
  • To assess the frequency of severe side effects and hospitalizations in this population.

Main Methods:

  • Retrospective analysis of California poison control cases from 2003-2018.
  • Inclusion criteria: children <6 years old, topical salicylate exposure, evaluated at a healthcare facility.

Main Results:

  • Of 599 cases, most had minor symptoms (e.g., gastrointestinal distress).
  • Six patients (1%) exhibited signs of salicylate toxicity (metabolic acidosis, tachypnea).
  • Seven patients (1.2%) were hospitalized, six of whom ingested liquid preparations.

Conclusions:

  • Topical salicylate ingestions in young children referred to healthcare facilities are associated with a low frequency of severe side effects.
  • Non-liquid topical salicylate ingestions have particularly low rates of severe outcomes and hospitalization.
  • Liquid formulations were more frequently linked to toxicity signs and hospital admission.
Abstract

Keywords:
Topical agentanalgesicingestionpediatricpoison controlsalicylatetoxicity

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