Salicylate poisoning

Primary prevention involves careful instruction to patients and families that even nonprescription salicylate-containing products, including topical agents, can be toxic and potentially fatal. In addition, patients should be advised to pay careful attention to medication ingredients to ensure they are not already taking a drug that contains salicylates. Dosage recommendations should be strictly adhered to. When in doubt, patients should consult their doctor or pharmacist. In general, oral salicylate formulations are no longer recommended for children because of concern for Reye syndrome.

The introduction of child-resistant packaging and smaller bottles of children's aspirin has played a significant role in decreasing the number of salicylate poisoning deaths in children in the US.[2]Chyka PA, Erdman AR, Christianson G, et al. Salicylate poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2007;45(2):95-131. https://www.tandfonline.com/doi/full/10.1080/15563650600907140 http://www.ncbi.nlm.nih.gov/pubmed/17364628?tool=bestpractice.com ​ In the UK, deaths by suicidal overdose of analgesics, including salicylates, were reduced by 22% in the year immediately after the introduction in 1998 of legislation limiting the pack size of analgesics that could be purchased.[5]Hawton K, Simkin S, Deeks J, et al. UK legislation on analgesic packs: before and after study of long term effect on poisonings. BMJ. 2004 Nov 6;329(7474):1076. https://www.bmj.com/content/329/7474/1076.full http://www.ncbi.nlm.nih.gov/pubmed/15516343?tool=bestpractice.com Nonfatal poisoning with salicylates was also reduced in the second and third years after the legislation was introduced. However, whether this is due to packaging or following a larger trend in decreasing suicides overall is unclear.