Managing Amitraz Poisoning: Epidemiological Data and Clinical Insights From a Tertiary Care Hospital in Southern India.

Background Amitraz is a formamidine insecticide and acaricide that acts on α2 adrenergic receptors. There is limited information in the literature regarding the toxicity of this compound and treatment of poisoning. Here, we have studied the epidemiology, symptoms, signs, complications, abnormalities in the tests, management, and prognosis of individuals who were admitted to a tertiary care hospital with acute amitraz intoxication. Methods This retrospective study was conducted at a tertiary care facility, Shri B. M. Patil Medical College, Hospital and Research Centre, Vijayapura, India. A total of 76 laboratory-confirmed cases of amitraz poisoning admitted to our hospital between January 2014 and March 2024 were included. All patients were analysed for symptoms, signs, laboratory abnormalities, complications, and management protocols. The data was analysed for frequency, percentage, mean, median, mode, standard deviation, and minimum and maximum values using IBM SPSS Statistics, version 26. Results Amitraz poisoning was most commonly observed in patients aged 20-29 years (36.8%); approximately 23.7% were younger than 20 years. The incidence was the lowest (9.2%) in people who were older than 60 years. A total of 97.4% of patients were from rural areas; out of 76, 50% were male patients and the remaining female patients. The most common presentation was vomiting (90.8%), followed by loss of consciousness (31.6%) and drowsiness (23.7%). Miosis was the most common sign seen in 73.7% of patients, 3.9% had mid-dilated pupils, 5.2% had mydriasis, and 17.1% had normal pupils. In total, 32.9% had hypotension, 10.5% had hypertension and 15.8% had hypothermia; 7.9% of patients had pneumonitis as found on chest X-rays, whereas X-rays of 1.3% patients showed pulmonary edema. ECG findings showed sinus tachycardia in 32.8% of patients, sinus bradycardia in 18.4%, and tall T-waves in only 1.3%, whereas 47.4% had a normal sinus rhythm. Around 39.5% had metabolic acidosis, and 9.2% had metabolic alkalosis based on arterial blood gas analysis. A total of 28.9% of patients needed mechanical ventilation. It was found that 96% of the patients recovered and 2.6% succumbed to death. Also, a patient's average stay in the hospital was 4.83±2.4 days. Conclusion The research emphasizes the importance of prompt gastric lavage to mitigate the hazardous effects of amitraz. Despite the lack of an antidote, supportive treatment is necessary to address cardiac effects like bradycardia and hypotension, as well as central nervous system depression and respiratory failure. Even though amitraz intoxication has a benign prognosis, these cases are to be closely observed and monitored in intensive care units.