School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
New South Wales Poisons Information Centre, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2021 Jun;57(6):883-887. doi: 10.1111/jpc.15348. Epub 2021 Jan 18.
To describe time trends in opioid exposures in children under 5 years, and to describe patient demographics, the medicines involved, the reasons for exposure and disposition.
A retrospective analysis of paediatric (<5 years of age) opioid exposure calls to the New South Wales Poisons Information Centre (NSWPIC, Australia's largest poison centre), 2004-2019. Joinpoint regression analysis was used to examine temporal trends.
There were 4807 cases of paediatric opioid exposure during the 16 year study period, with an average of 300 exposures per year. Exposures increased, 2004-2007, with an annual percentage change (APC) of 14.6% (95% CI = 4.3 to 26.0%), then decreased, 2007-2016, APC -3.4% (95% CI = -5.3 to -1.3%). A steeper decrease was observed after 2016, APC -14.1% (95% CI = -21.8 to -5.6%). The overall APC was -2.3% (95% CI = -4.7 to 0.2%), 2004-2019. Accidental exposures accounted for 86% of calls (4137). The majority of calls were from family members regarding exposures that happened at home, highlighting the need for safety initiatives. The preparations most frequently involved were paracetamol/opioid combination products (primarily codeine), 53% (2566) and ibuprofen/opioid combinations 14% (650). Twenty-two percent of cases were referred to a hospital (1062), and a further 15% (719) of calls originated from hospital staff.
Opioid exposures in young Australian children continue to occur; however, the rate has declined since 2007. Safe storage and parent education initiatives could further reduce the burden of paediatric opioid poisoning in Australia.
描述 5 岁以下儿童阿片类药物暴露的时间趋势，并描述患者人口统计学特征、涉及的药物、暴露原因和处理方式。
对 2004 年至 2019 年澳大利亚最大的毒物中心——新南威尔士毒物信息中心（NSWPIC）接到的儿童（<5 岁）阿片类药物暴露电话进行回顾性分析。采用 Joinpoint 回归分析来检测时间趋势。
在 16 年的研究期间，共有 4807 例儿童阿片类药物暴露，每年平均暴露 300 例。暴露情况呈上升趋势，2004 年至 2007 年，年变化百分比（APC）为 14.6%（95%可信区间：4.3 至 26.0%），随后在 2007 年至 2016 年下降，APC 为-3.4%（95%可信区间：-5.3 至 -1.3%）。2016 年后下降更为陡峭，APC 为-14.1%（95%可信区间：-21.8 至 -5.6%）。2004 年至 2019 年，总体 APC 为-2.3%（95%可信区间：-4.7 至 0.2%）。意外暴露占呼叫的 86%（4137）。大多数电话是家庭成员打来的，涉及家中发生的暴露事件，这突显了安全举措的必要性。涉及的制剂最常为对乙酰氨基酚/阿片类药物复方制剂（主要为可待因），占 53%（2566），其次为布洛芬/阿片类药物复方制剂占 14%（650）。22%（1062）的病例被转至医院，另有 15%（719）的电话来自医院工作人员。
澳大利亚幼儿阿片类药物暴露仍在继续，但自 2007 年以来，该比率有所下降。安全储存和家长教育举措可进一步降低澳大利亚儿童阿片类药物中毒的负担。
