Oximes in paediatric organophosphate poisoning: what is the point?

Background: Poisoning with organophosphate (OP) insecticides is a commonly fatal entity globally – particularly in developing countries. It carries a high morbidity, mortality and admission rate to intensive care units. Standard treatment involves the use of atropine and an oxime. There is a paucity of paediatric literature, especially with regards to treatment regimens. Aims: To critically evaluate the utility of OP poisoning antidotes: atropine and oximes. Discussion: This critical review reinforces the need for treatment regimens for children poisoned with OPs to be based on atropine allied to supportive care. The literature concerning oximes is poor, making it hard to recommend their use. Conclusions: Standardisation of atropine regimens in OP poisoning is needed before studying the use of oximes.