Abstract
Dear Editor, Biebl et al. [1] described, in a 13-year-old patient, serious adverse events after receiving four phosphates enemas within 24 h. The authors fail to note that the dose of sodium phosphates enema given was an extreme overdose. First, the recommended adult dose of sodium phosphates enema is one 133-mL bottle (to deliver a dose of 118 mL containing 19 g of monobasic sodium phosphate monohydrate and 7 g of dibasic sodium phosphate heptahydrate [2]) within 24 h; this patient received four bottles within 24 h. Second, while the patient is an adult by the European Medicines Agency definition (http://www.emea.europa.eu/ htms/human/qrd/docs/qrdterms.pdf, accessed on November 13, 2008), the patient’s diminutive size of 18.2 kg resulting from Costello’s syndrome was indicative that a children’s enema would have been much more appropriate. Third, although Biebl et al. [1] described the use of 125-mL Fleet enema bottle, Fleet enema of any size is not marketed in Austria. Proper dosing and timing instructions for Fleet enema are available on the Fleet Laboratories Web site, www. fleetlabs.com.
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