Morbidity and mortality from toxic
alcohols like
ethylene glycol and
methanol remain prevalent worldwide. The introduction of
fomepizole, a potent blocker of
alcohol dehydrogenase, has modified current practice over the last 15 years. The aim of the study was to describe the characteristics of toxic alcohol
poisoning reported to US
poison centers, the trends in the incidence of
antidote use and
hemodialysis treatment, as well as the related mortality. A retrospective study of all electronic entries from the AAPCC National
Poison Data System database, from the years 2000 to 2013 was reviewed. When considering all exposures, the great majority of patients had a benign outcome. Major effects (e.g., life threatening) occurred in 2.1% and 4.9% of
methanol and
ethylene glycol cases, respectively. Mortality rates were similar for both toxic
alcohols, approximately 0.6%. When only considering ingestions reported to healthcare facilities, a major effect was reported in 9.5% and 20.5%, and the mortality rate was 2.9% and 2.4% for
methanol and
ethylene glycol exposures, respectively, and remained constant over time. The use of
fomepizole increased statistically over the study period while that of
ethanol decreased, until it became proportionally negligible by 2012-2013. The use of
hemodialysis significantly decreased in "Early"
ethylene glycol exposures during the study period. Similar to other reports, it appears that the use of
fomepizole has largely supplanted
ethanol as the
antidote of choice in toxic alcohol exposures and may decrease the requirements for
hemodialysis in patients poisoned with
ethylene glycol who have no
acidosis and normal kidney function.