Efficacy of magnesium citrate cathartic in pediatric toxic ingestions.
OBJECTIVE
To investigate the efficacy of magnesium citrate in reducing gastrointestinal transit time of activated charcoal in children.


METHODS
A prospective, randomized, clinical comparison of four magnesium doses.


METHODS
Urban children's hospital emergency department.


METHODS
Children aged 1 month to 6 years who presented for management of an acute toxic ingestion.


METHODS
Each child received 1 g/kg activated charcoal combined with a randomly assigned dose of a 6% solution of magnesium citrate: 0 mL/kg, 4 mL/kg (standard recommended dose), 6 mL/kg, or 8 mL/kg. The primary outcome measure was the interval to first activated charcoal-containing stool, which was determined by follow-up telephone call or review of the medical record.


RESULTS
Sixty-four children were enrolled. Median times to first charcoal stool were 19.5 hours (0 mL/kg), 13.0 hours (4 mL/kg), 14.0 hours (6 mL/kg), and 12.0 hours (8 mL/kg). Intergroup differences were significant by Kruskal-Wallis analysis of variance (P = .0035).


CONCLUSIONS
Magnesium citrate reduces gastrointestinal transit times of activated charcoal stools when administered to children who receive activated charcoal for a toxic ingestion. Further study is needed to determine the clinical value of this reduction.
Sue
Y J
YJ
Department of Pediatrics, Children's Hospital, Harvard Medical School, Massachusetts Poison Control System, Boston.
Woolf
A
A
Shannon
M
M
D000863:Antacids / Q000008:administration & dosage*; D002606:Charcoal / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002951:Citrates / Q000008:administration & dosage* / Q000494:pharmacology; D019343:Citric Acid; D005772:Gastrointestinal Transit / Q000187:drug effects; D006801:Humans; D007223:Infant; D011041:Poisoning / Q000188:drug therapy*; D011446:Prospective Studies
D000863:Antacids; D002951:Citrates; D002606:Charcoal; D019343:Citric Acid