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Research Article

Pralidoxime in Acute Organophosphorus Insecticide Poisoning—A Randomised Controlled Trial

  • Michael Eddleston mail,

    eddlestonm@yahoo.com

    Affiliations: Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, United Kingdom, Ox-Col Collaboration, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka, South Asian Clinical Toxicology Research Collaboration, Sri Lanka

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  • Peter Eyer,

    Affiliation: Walther Straub Institute of Pharmacology and Toxicology, Ludwig Maximilians University, Munich, Germany

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  • Franz Worek,

    Affiliation: Bundeswehr Institute of Pharmacology and Toxicology, Munich, Germany

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  • Edmund Juszczak,

    Affiliation: Centre for Statistics in Medicine, Wolfson College, University of Oxford, England

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  • Nicola Alder,

    Affiliation: Centre for Statistics in Medicine, Wolfson College, University of Oxford, England

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  • Fahim Mohamed,

    Affiliations: Ox-Col Collaboration, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka, South Asian Clinical Toxicology Research Collaboration, Sri Lanka

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  • Lalith Senarathna,

    Affiliations: Ox-Col Collaboration, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka, South Asian Clinical Toxicology Research Collaboration, Sri Lanka

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  • Ariyasena Hittarage,

    Affiliation: Anuradhapura General Hospital, North Central Province, Sri Lanka

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  • Shifa Azher,

    Affiliation: Polonnaruwa General Hospital, North Central Province, Sri Lanka

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  • K. Jeganathan,

    Affiliation: Anuradhapura General Hospital, North Central Province, Sri Lanka

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  • Shaluka Jayamanne,

    Affiliation: Polonnaruwa General Hospital, North Central Province, Sri Lanka

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  • Ludwig von Meyer,

    Affiliation: Institute of Legal Medicine, Ludwig Maximilians University, Munich, Germany

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  • Andrew H. Dawson,

    Affiliations: South Asian Clinical Toxicology Research Collaboration, Sri Lanka, School of Public Health, University of Newcastle, Australia

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  • Mohamed Hussain Rezvi Sheriff,

    Affiliations: Ox-Col Collaboration, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka, South Asian Clinical Toxicology Research Collaboration, Sri Lanka

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  • Nick A. Buckley

    Affiliations: South Asian Clinical Toxicology Research Collaboration, Sri Lanka, Professorial Unit, Department of Medicine, University of New South Wales, Sydney, Australia

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  • Published: June 30, 2009
  • DOI: 10.1371/journal.pmed.1000104

About the Authors

Michael Eddleston
Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, United Kingdom
Michael Eddleston, Fahim Mohamed, Lalith Senarathna, Mohamed Hussain Rezvi Sheriff
Ox-Col Collaboration, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka
Michael Eddleston, Fahim Mohamed, Lalith Senarathna, Andrew H. Dawson, Mohamed Hussain Rezvi Sheriff, Nick A. Buckley
South Asian Clinical Toxicology Research Collaboration, Sri Lanka
Peter Eyer
Walther Straub Institute of Pharmacology and Toxicology, Ludwig Maximilians University, Munich, Germany
Franz Worek
Bundeswehr Institute of Pharmacology and Toxicology, Munich, Germany
Edmund Juszczak, Nicola Alder
Centre for Statistics in Medicine, Wolfson College, University of Oxford, England
Ariyasena Hittarage, K. Jeganathan
Anuradhapura General Hospital, North Central Province, Sri Lanka
Shifa Azher, Shaluka Jayamanne
Polonnaruwa General Hospital, North Central Province, Sri Lanka
Ludwig von Meyer
Institute of Legal Medicine, Ludwig Maximilians University, Munich, Germany
Andrew H. Dawson
School of Public Health, University of Newcastle, Australia
Nick A. Buckley
Professorial Unit, Department of Medicine, University of New South Wales, Sydney, Australia

Corresponding Author

Email: eddlestonm@yahoo.com

Competing Interests

The authors have declared that no competing interests exist.

Author Contributions

ICMJE criteria for authorship read and met: ME PE FW EJ NA FM LS AH SA KJ SJ LvM AHD NAB. Agree with the manuscript's results and conclusions: ME PE FW EJ NA FM LS AH SA KJ SJ LvM AHD MHRS NAB. Designed the experiments/the study: ME FW EJ MHRS NAB. Analyzed the data: ME PE FW FM AHD MHRS. Collected data/did experiments for the study: ME PE FW NA LS AH KJ LvM NAB. Enrolled patients: ME LS AH SA KJ SJ. Wrote the first draft of the paper: ME. Contributed to the writing of the paper: ME PE FW EJ NA FM LS SA AHD MHRS NAB. Responsible for the analyses of the PK/PD data: PE. Determination of cholinesterase data and analysis of cholinesterase, pesticide and oxime data: FW. Conducted the randomisation with the trial programmer, and performed interim analysis for the Chair of the Independent Data Monitoring Committee: EJ. Ran the logistics of this study in one of the centres and was involved in data auditing: FM. Contributed to the study at the initial stage of designing: SJ. Responsible for poison concentration data: LvM. Oversaw the two clinical centres involved in the study, examined and validated the primary data: AHD.