Antidotes and their availability in South Africa

Abstract

Introduction. The availability of antidotes is essential and often lifesaving in management of certain poisonings. Surveys conducted in a number of countries have demonstrated inadequate availability of antidotes. Since no similar studies have been published for South Africa, it was decided to investigate the local availability of antidotes. Methods. A questionnaire on the availability of antidotes was sent to government and private hospital pharmacies. The list of commonly required antidotes and supportive agents was compiled from WHO guidelines. Results. The response rate was 94%. None of the responding hospitals stocked all of the antidotes on the list. Tertiary hospitals had the highest percentage (67%) of antidotes available. Discussion. Seven antidotes were not stocked by any of the hospitals, including digoxin-specific antibody fragments, dimercaprol, calcium disodium edetate, fomepizole, intravenous pyridoxine, silibinin, and succimer. Five of these are not registered as medicines in South Africa. Conclusions. Poison information centers should work with local drug coding committees to improve availability of important antidotes.