Emamectin Poisoning in Thailand: Clinical Characteristics and Outcomes
Issued Date
2024-09-01
Resource Type
eISSN
23056304
Scopus ID
2-s2.0-85205237896
Journal Title
Toxics
Volume
12
Issue
9
Rights Holder(s)
SCOPUS
Bibliographic Citation
Toxics Vol.12 No.9 (2024)
Suggested Citation
Trakulsrichai S., Sittiyuno P., Tansuwannarat P., Tongpoo A. Emamectin Poisoning in Thailand: Clinical Characteristics and Outcomes. Toxics Vol.12 No.9 (2024). doi:10.3390/toxics12090668 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/101494
Title
Emamectin Poisoning in Thailand: Clinical Characteristics and Outcomes
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Corresponding Author(s)
Other Contributor(s)
Abstract
Emamectin benzoate (Emamectin) is a broad-spectrum insecticide. Current data regarding emamectin poisoning in humans are very limited. We performed a 10-year retrospective cross-sectional study (2011–2020) using data from the Ramathibodi Poison Center database to examine the clinical characteristics and outcomes in patients exposed to emamectin. Eighty-eight patients were included. Most of the patients were male (72.7%) and exposure was frequently oral (86.4%) and intentional (67.0%).Their mean age was 42.8 years. The clinical presentations included gastrointestinal tract symptoms (62.5%), neurological symptoms (27.3%) including seizures, respiratory symptoms (6.8%), and local effects (12.5%). At presentation, the majority of patients exhibited normal consciousness and vital signs. Eleven patients showed no obvious clinical effects. Initially, 15 patients had metabolic acidosis and 11 had hypokalemia. Overall, 46 and 52 patients were administered gastric lavage and activated charcoal, respectively. Most patients (78.4%) were hospitalized, with a median hospital stay of 40 h, and generally received supportive treatment. Eight patients were intubated for ventilator support and one received inotropic drugs. Most patients (90.9%) showed no or minor outcomes; however, two patients died. The presence of Glasgow Coma Scale (GCS) <15 differed significantly (p < 0.001) between patients with no or minor outcomes (n = 80) and those with moderate or fatal outcomes (n = 8). In conclusion, emamectin poisoning mainly caused no or minor clinical effects. A low GCS at presentation was associated with worse outcomes. Therefore, patients who present with low GCS should be closely observed, monitored, and properly managed during hospitalization.