Bailey G P, Rehman B, Wind K, Wood D M, Thanacoody R, Nash S, Archer Jrh, Eddleston M, Thompson J P, Vale J A, Thomas Shl, Dargan P I
Department of Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Department of Emergency Medicine, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
Eur J Hosp Pharm. 2016 May;23(3):145-150. doi: 10.1136/ejhpharm-2015-000802. Epub 2015 Nov 18.
A 2010/2011 audit of the Royal College of Emergency Medicine (RCEM) National Poisons Information Service (NPIS) UK guidelines on antidote availability demonstrated variable stocking of antidotes for the management of poisoned patients; the guidelines were updated and republished in 2013.
To assess if antidote stocking has improved since the 2010/2011 audit and introduction of the 2013 guidelines.
Questionnaires were sent to Chief Pharmacists at all 215 acute hospitals in England, Wales and Northern Ireland in October 2014. Data were collected on the timing of availability (category A antidotes should be available immediately, category B within 1 h and category C can be held supraregionally) and stock levels.
169 (78.6%) responses were received. Atropine, calcium gluconate and flumazenil (category A) were the only antidotes available in all hospitals within the recommended time and stock levels. Forty-one (24.3%) hospitals held every category A antidote; this increased to 81 (47.9%) for those holding at least one cyanide antidote and all other category A antidotes. The proportion of hospitals stocking category A/B antidotes within the recommended time increased for 20 (90.9%) category A/B antidotes. Fomepizole (category B) availability increased to 62.1% of hospitals from 11.4% in 2010/2011. Other than penicillamine (63.3% hospitals), there was poor availability (2.4%-36.1%) of category C antidotes.
Availability of category A and B antidotes has improved since the 2010/2011 audit and 2013 guidelines. However, there remains significant variability particularly for category C antidotes. More work is required to ensure that those treating poisoned patients have timely access to antidotes focusing particularly on category C antidotes.
2010/2011年对英国皇家急诊医学院（RCEM）国家毒物信息服务（NPIS）关于解毒剂供应的指南进行的一项审核表明，用于中毒患者治疗的解毒剂库存情况不一；该指南于2013年更新并重新发布。
评估自2010/2011年审核及2013年指南发布以来解毒剂库存情况是否有所改善。
2014年10月，向英格兰、威尔士和北爱尔兰的所有215家急症医院的首席药剂师发送了调查问卷。收集了关于供应时间（A类解毒剂应立即可用，B类在1小时内可用，C类可在区域以上储备）和库存水平的数据。
共收到169份（78.6%）回复。阿托品、葡萄糖酸钙和氟马西尼（A类）是所有医院在推荐时间和库存水平内唯一可用的解毒剂。41家（24.3%）医院储备了每一种A类解毒剂；对于那些储备了至少一种氰化物解毒剂和所有其他A类解毒剂的医院，这一比例增至81家（47.9%）。在推荐时间内储备A/B类解毒剂的医院比例，对于20种（90.9%）A/B类解毒剂有所增加。甲吡唑（B类）的可用医院比例从2010/2011年的11.4%增至62.1%。除青霉胺外（63.3%的医院有储备），C类解毒剂的可用率较低（2.4% - 36.1%）。
自2010/2011年审核及2013年指南发布以来，A类和B类解毒剂的供应情况有所改善。然而，尤其是C类解毒剂，仍存在显著差异。需要开展更多工作，以确保治疗中毒患者的人员能够及时获得解毒剂，尤其要关注C类解毒剂。
