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Evaluation of Paracetamol Overdoses in the Pediatric Emergency Department

Ahmet Serkan Ozcan1, Betul Ozturk1, Bilge Akkaya1

  • 1Department of Pediatric Emergency Care, Etlik City Hospital, Ankara, Türkiye.

Turkish Archives of Pediatrics
|November 19, 2025
PubMed

Insights

Most pediatric paracetamol overdoses involve tablets, with intentional ingestions more frequent in adolescent females. Clinical evaluation is crucial for all cases, especially intentional ones, to ensure patient safety.

Area of Science:

  • Pediatric Emergency Medicine
  • Clinical Toxicology
  • Pharmacology

Background:

  • Paracetamol (acetaminophen) is a common analgesic and antipyretic used globally in pediatric populations.
  • Overdose cases present a significant challenge in pediatric emergency departments, necessitating a thorough understanding of patient demographics and outcomes.

Purpose of the Study:

  • To characterize pediatric patients presenting with paracetamol overdose.
  • To evaluate the clinical outcomes and management strategies for these patients.

Main Methods:

  • A retrospective cross-sectional study was conducted on 112 pediatric patients (1 month to 18 years) admitted for paracetamol overdose.
  • Patients were categorized into intentional and unintentional ingestion groups.
  • Data analyzed included patient demographics, ingestion details, serum paracetamol levels, clinical outcomes, and treatment provided.

Main Results:

  • Intentional overdoses (63.4%) were more common in older adolescent females and associated with psychiatric disorders and multidrug ingestions.
  • Tablet formulations were the most frequent form of ingestion (78.6%).
  • Hepatotoxicity and nephrotoxicity were rare and mild; all patients were discharged in stable condition without mortality.

Conclusions:

  • Paracetamol overdose in children often involves tablet formulations, with intentional ingestions predominantly seen in adolescent females.
  • Clinical assessment is vital for all overdose cases, irrespective of the reported intake amount.
  • Prompt and appropriate management, including N-acetylcysteine administration when indicated, leads to favorable outcomes.
Abstract

Keywords:
N-acetylcysteineoverdoseparacetamolpediatric emergency

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