OBJECTIVES: This study was conducted to investigate the various antidotes used in treating poisoned patients in a hospital.

METHODS: A prospective observational study was conducted from November 2020-April 2021. Patient demographics, information on the poisoning agent, treatment provided and antidotes used were studied. The collected data was reviewed to analyze the appropriateness of the antidotes prescribed according to the institutional poison protocols, Micromedex and other relevant guidelines. The 2015 edition of National List of Essential Medicines of India (NLEM) was used to verify if the antidotes given had reasonable costs.

RESULTS: Of the 117 patients, 71 (60.68%) patients were admitted with cases of suicidal poisoning, and were found to have a 24 fold higher chance of suffering from severe poisoning (OR=25.79, 95% CI= 1.18 – 56.45, P=0.039). In accidental poisoning, general cases were found to have a 0.95 fold higher chance of resulting in severe poisoning [0.11-0.51, 95%CI (p=0.009)]. Pesticides were the most implicated agents in poisoning (44, 37.6%). Atropine was the most widely used antidote in 30 (36.85%) patients followed by anti-snake venom (ASV) in 15 (18.29%) cases. Intravenous (IV) was the most common route of antidote administration (51.21%). In 70 (85.36%) patients, antidote was given according to the hospital poison protocol and was justified. The antidotes used in 77 (93.9%) patients were included in NLEM 2015 and in 15 (18.29%) cases a cheaper alternative of the antidote could have been prescribed. After therapy, 93 (79.48%) patients were discharged post recovery

CONCLUSIONS: Proper antidote use and administration can reduce morbidity and mortality in poisoned patients. Thus, it is crucial that clinicians are updated on the current information and trends in antidote utilization. It is also important for hospitals to offer high-quality treatment at the lowest possible cost so as to reduce the financial burden on the patient.