Publication:

Comparison of efficacy of atropine versus atropine with pralidoxime in organophosphorus poisoning

Background Comparison of the efficacy of atropine alone against atropine with pralidoxime in the treatment of organophosphorus (OP) poisoning.

Methods Forty two patients between the age group of 18 to 65 years, treated for OP poisoning and matched for baseline characteristics, were included in two groupsbased on treatment received as “Atropine only” or “Atropine plus pralidoxime(PAM)”.Main outcomes of the study were ICU stay, total hospital stay and mortality. ICU and hospital stay were compared using ‘t’ test while  mortality was compared using Fisher’s exact test.

Results Total hospital stay was not significantly different between the treatment groups (95% CI of difference: -4.227, 0.784). Length of stay was also not significantly different between patients who received atropine plus PAM within 6 hours of consumption of poison and those who received 6 hours later (95% CI of difference: -4.154, 0.954; p value: 0.2).

Conclusion Our data supports the use of only atropine over atropine plus PAM in patients with OP poisoning on account of no significant difference /reduction of hospital/ICU stay and mortality in the latter group. However, a study with a larger sample needs to be conducted, to be able to draw a definitive conclusion.