Is this the epitaph for multiple-dose activated charcoal?

摘要

In today's Lancet, Michael Eddleston and colleagues1 report a large randomised trial on the efficacy of activated charcoal in self-poisoned patients in rural south Asia. The cohort comprised three study groups with more than 1500 patients each, who were treated without activated charcoal, with a single-dose, or with six doses of activated charcoal every 4 h. The most common poisons ingested were seeds of yellow oleander (36%) and anticholinesterase pesticides (28%). The overall death rate was 6.7% and did not differ between the three groups. The authors conclude that routine administration of multidose activated charcoal cannot be recommended for this specific setting.