Amatoxin poisoning treatment decision-making: pharmaco-therapeutic clinical strategy assessment using multidimensional multivariate statistic analysis.
Ninety percent of fatal higher fungus poisoning is due to amatoxin-containing mushroom species. In addition to absence of antidote, no chemotherapeutic consensus was reported. The aim of the present study is to perform a retrospective multidimensional multivariate statistic analysis of 2110 amatoxin poisoning clinical cases, in order to optimize therapeutic decision-making. Our results allowed to classify drugs as a function of their influence on one major parameter: patient survival. Active principles were classified as first intention, second intention, adjuvant or controversial pharmaco-therapeutic clinical intervention. We conclude that (1) retrospective multidimensional multivariate statistic analysis of complex clinical dataset might help future therapeutic decision-making and (2) drugs such as silybin, N-acetylcystein and putatively ceftazidime are clearly associated, in amatoxin poisoning context, with higher level of patient survival.
Poucheret
Patrick
P
Laboratoire de Pharmacologie et Physiopathologie Expérimentale, UMR 95 Qualisud, Faculté de Pharmacie, Université Montpellier I, 15 Avenue Charles Flahault, F-34093 Montpellier Cedex 5, France. patrick.poucheret@univ-montp1.fr
Fons
Françoise
F
Doré
Jean Christophe
JC
Michelot
Didier
D
Rapior
Sylvie
S
D000111:Acetylcysteine / Q000627:therapeutic use; D000465:Algorithms; D000546:Amanitins / Q000506:poisoning*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D002442:Ceftazidime / Q000627:therapeutic use; D016208:Databases, Factual; D003657:Decision Making; D003662:Decision Theory; D005163:Factor Analysis, Statistical; D006801:Humans; D015999:Multivariate Analysis; D009145:Mushroom Poisoning / Q000188:drug therapy / Q000628:therapy*; D012189:Retrospective Studies; D000077385:Silybin; D012838:Silymarin / Q000627:therapeutic use; D013534:Survival; D015996:Survival Rate
D000546:Amanitins; D000900:Anti-Bacterial Agents; D000975:Antioxidants; D012838:Silymarin; D000077385:Silybin; C018207:amatoxin; D002442:Ceftazidime; D000111:Acetylcysteine