A case series of xylometazoline overdose in children.
BACKGROUND
Serious intoxications associated with low doses of imidazolines have been reported. Therefore, the treatment advice for children with xylometazoline overdose is usually to observe the child in the hospital, even after exposure to very low doses. Our aim was to determine the frequency of severe symptoms after xylometazoline exposure, and the systemic dose of xylometazoline below which asymptomatic children do not need to be hospitalized for observation.


METHODS
From May 2002 until December 2004, we prospectively collected data on all consecutive cases of xylometazoline exposure in children <6 years old reported to our poisons centre. Follow-up information was collected. The systemic dose was calculated and the frequency of severe symptoms was observed.


RESULTS
During 32 months, we included 101 cases of xylometazoline exposure in children. For 63 out of these 101 cases, follow-up information could be collected. No severe symptoms were observed after exposure to xylometazoline doses reported to be below 0.4 mg/kg (95% confidence interval: 0-6%).


CONCLUSIONS
We conclude that less than 6% of children exposed to xylometazoline, at doses reported to be less than 0.4 mg/kg body weight, may develop symptoms that require hospitalization.
van Velzen
Agnes G
AG
National Poisons Information Centre, National Institute for Public Health and the Environment, Bilthoven, The Netherlands. agnes.van.velzen@RIVM.nl
van Riel
Antoinette J H P
AJ
Hunault
Claudine
C
van Riemsdijk
Tessa E
TE
de Vries
Irma
I
Meulenbelt
Jan
J
D000281:Administration, Intranasal; D000284:Administration, Oral; D000316:Adrenergic alpha-Agonists / Q000506:poisoning*; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D062787:Drug Overdose; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007093:Imidazoles / Q000506:poisoning*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D014663:Nasal Decongestants / Q000506:poisoning*; D011039:Poison Control Centers; D011446:Prospective Studies
D000316:Adrenergic alpha-Agonists; D007093:Imidazoles; D014663:Nasal Decongestants; C009695:xylometazoline