Amoxicillin overdose in the pediatric emergency department: A descriptive study

Objective: To describe the characteristics of pediatric patients treated in the emergency department due to amoxicillin overdosing. Method: A retrospective single-center observational study was conducted on patients aged 0 to 16 years treated in a pediatric emergency department due to amoxicillin overdosing between 2011 and 2021. Epidemiological and anthropometric data was collected as well as information on the circumstances of overdosing, clinical manifestations, emergency department management, and discharge destination. Results: The study comprised 15 patients, 66.6% of them male, with a median age of 3.8 years (interquartile range: 1.9). The most frequent cause of overdosing was accidental ingestion (8/15; 53.3%). Amoxicillin was mainly ingested in liquid form, except for one case with autolytic attempt, where it was ingested in the form of tablets. Eighty percent of subjects (12/15) received a single dose of the drug. The median time to presentation to emergency department was 2.1 hours from ingestion (interquartile range: 2.7) and the median dose of amoxicillin was 219 mg/kg/dose (interquartile range: 148). All patients were asymptomatic, with a normal physical examination. Blood tests were performed in 7 patients (46.6%) and urinary sediment analysis in 2 (13.3%), all of them without alterations. Activated charcoal was administered to 5 (33.3%), patients with a median time to administration of one hour (interquartile range: 1.2). All patients were discharged to their homes. Eleven cases (73.3%) required withdrawal of amoxicillin. Conclusions: Amoxicillin overdosing in this study did not appear to result in adverse effects, despite the fact that the recommended doses were significantly exceeded.