title: The effects of penicillin and cephalosporin ingestions in children less than six years of age.
abstract: Oral antibiotic ingestions account for 1-2% of all pediatric exposures reported to regional poison information centers. The majority of these pediatric exposures involve the ingestion of penicillin or cephalosporin derivatives. How much can be ingested before gastric emptying is necessary is a controversial issue in the management of these cases. A study was designed to determine if children less than 6 years of age could safely ingest a maximum of 250 mg/kg of a penicillin or cephalosporin derivative without significant adverse effects. Sixty-one cases were prospectively collected. The average antibiotic amount ingested was 113.3 mg/kg (17.8-250.0 mg/kg). Each patient was evaluated for symptoms at the time of the initial call and at 6-12 degrees, 24 degrees, 48 degrees, and 72 degrees. Eighty-four percent of the children remained asymptomatic during the evaluation period. Eight of 13 symptomatic patients developed 1 or 2 episodes of diarrhea; 2 developed a rash. Amoxicillin suspension was involved in 70% of the cases, followed by cefachlor suspension 11%, and amoxicillin tablets 5%. Liquid preparations accounted for 90% of the cases and solid dosage forms, the remainder. The data strongly suggests that ingestions of less than 250 mg/kg of these products are not associated with significant outcomes and do not require gastric emptying.
authors.affiliation: Pittsburgh Poison Center, Children's Hospital of Pittsburgh, PA.
authors.forename: B
authors.initials: B
authors.lastname: Swanson-Biearman
authors.forename: B S
authors.initials: BS
authors.lastname: Dean
authors.forename: G
authors.initials: G
authors.lastname: Lopez
authors.forename: E P
authors.initials: EP
authors.lastname: Krenzelok
mesh_terms: D002511:Cephalosporins / Q000506:poisoning*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010406:Penicillins / Q000506:poisoning*; D010414:Pennsylvania
chemical_list: D002511:Cephalosporins; D010406:Penicillins