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.
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
Patrick
P
Poucheret
Françoise
F
Fons
Jean Christophe
JC
Doré
Didier
D
Michelot
Sylvie
S
Rapior
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