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Taking stock: UK national antidote availability increasing, but further improvements are required

Lookup NU author(s): Dr Ruben ThanacoodyORCiD, Professor Simon ThomasORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Background A 2010/2011 audit of the Royal College of Emergency Medicine (RCEM) National Poisons Information Service (NPIS) UK guidelines on antidote availability demonstrated variable stocking of antidotes for the management of poisoned patients; the guidelines were updated and republished in 2013.Aim To assess if antidote stocking has improved since the 2010/2011 audit and introduction of the 2013 guidelines.Methods Questionnaires were sent to Chief Pharmacists at all 215 acute hospitals in England, Wales and Northern Ireland in October 2014. Data were collected on the timing of availability (category A antidotes should be available immediately, category B within 1 h and category C can be held supraregionally) and stock levels.Results 169 (78.6%) responses were received. Atropine, calcium gluconate and flumazenil (category A) were the only antidotes available in all hospitals within the recommended time and stock levels. Forty-one (24.3%) hospitals held every category A antidote; this increased to 81 (47.9%) for those holding at least one cyanide antidote and all other category A antidotes. The proportion of hospitals stocking category A/B antidotes within the recommended time increased for 20 (90.9%) category A/B antidotes. Fomepizole (category B) availability increased to 62.1% of hospitals from 11.4% in 2010/2011. Other than penicillamine (63.3% hospitals), there was poor availability (2.4%-36.1%) of category C antidotes.Conclusions Availability of category A and B antidotes has improved since the 2010/2011 audit and 2013 guidelines. However, there remains significant variability particularly for category C antidotes. More work is required to ensure that those treating poisoned patients have timely access to antidotes focusing particularly on category C antidotes.

Publication metadata

Author(s): Bailey GP, Rehman B, Wind K, Wood DM, Thanacoody R, Nash S, Archer JRH, Eddleston M, Thompson JP, Vale JA, Thomas SHL, Dargan PI

Publication type: Article

Publication status: Published

Journal: European Journal of Hospital Pharmacy

Year: 2016

Volume: 23

Issue: 3

Pages: 145-150

Print publication date: 01/05/2016

Online publication date: 18/11/2015

Acceptance date: 05/10/2015

Date deposited: 21/06/2016

ISSN (print): 2047-9956

ISSN (electronic): 2047-9964

Publisher: BMJ Publishing Group


DOI: 10.1136/ejhpharm-2015-000802


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