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Activated charcoal for pediatric poisonings: the universal antidote?

Lapus, Robert Michael

Current Opinion in Pediatrics: April 2007 - Volume 19 - Issue 2 - p 216–222
doi: 10.1097/MOP.0b013e32801da2a9
Therapeutics and toxicology

Purpose of review For decades, activated charcoal has been used as a ‘universal antidote’ for the majority of poisons because of its ability to prevent the absorption of most toxic agents from the gastrointestinal tract and enhance the elimination of some agents already absorbed. This manuscript will review the history of activated charcoal, its indications, contraindications, and the complications associated with its use as reported in the literature.

Recent findings Recent randomized prospective studies, although with small numbers, have shown no difference in length of hospital stay, morbidity, and mortality between groups who received and did not receive activated charcoal. No study has had sufficient numbers to satisfactorily address clinical outcome in patients who received activated charcoal less than 1 h following ingestion.

Summary If used appropriately, activated charcoal has relatively low morbidity. Due to the lack of definitive studies showing a benefit in clinical outcome, it should not be used routinely in ingestions. AC could be considered for patients with an intact airway who present soon after ingestion of a toxic or life-threatening dose of an adsorbable toxin. The appropriate use of activated charcoal should be determined by the analysis of the relative risks and benefits of its use in each specific clinical scenario.

Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA

Correspondence to Robert Michael Lapus MD, Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Alabama at Birmingham School of Medicine, 1600 7th Ave South Midtown Center 205, Birmingham, AL 35233, USA Tel: +1 205 939 9587; fax: +1 205 475 4623; e-mail: rlapus@peds.uab.edu

© 2007 Lippincott Williams & Wilkins, Inc.