A Study on Comparative Evaluation of Add-on Pralidoxime Therapy over Atropine in the Management of Organophosphorus Poisoning in a Tertiary Care Hospital.

ABSTRACT

Since its discovery in 1956, pralidoxime has been used in the management of organophosphorus poisoning (OP) in addition to atropine. While efficacy of atropine is proved beyond doubt, clinical experience with pralidoxime has led to widespread controversies about its efficacy in treatment of OP poisoning. In this study we compared the efficacy of add-on pralidoxime therapy over therapy with atropine alone in OP poisoning. In this open-label, parallel-group clinical study, patients of OP poisoning, presenting in emergency department of a tertiary care district hospital, were randomly allocated to receive either atropine or atropine plus pralidoxime. The parameters used for efficacy assessment were mortality rate, requirement of ventilator and duration of stay in the hospital in either of the two treatment arms.The mortality rate, requirement of ventilator and duration of hospital stay in the two treatment arms failed to show any statistically significant difference. Add-on pralidoxime therapy over atropine monotherapy, does not offer any significant advantage in the management of OP poisoning.