Efficacy of Magnesium Citrate Cathartic in Pediatric Toxic Ingestions

Study objective: To investigate the efficacy of magnesium citrate in reducing gastrointestinal transit time of activated charcoal in children. Design: A prospective, randomized, clinical comparison of four magnesium doses. Setting: Urban children's hospital emergency department. Participants: Children aged 1 month to 6 years who presented for management of an acute toxic ingestion. Intervention: Each child received 1 g/kg activated charcoal combined with a randomly assigned dose of a 6% solution of magnesium citrate: 0 mL/kg, 4 mL/kg (standard recommended dose), 6 mL/kg, or 8 mL/kg. The primary outcome measure was the interval to first activated charcoal-containing stool, which was determined by follow-up telephone call or review of the medical record. Results: Sixty-four children were enrolled. Median times to first charcoal stool were 19.5 hours (0 mL/kg), 13.0 hours (4 mL/kg), 14.0 hours (6 mL/kg), and 12.0 hours (8 mL/kg). Intergroup differences were significant by Kruskal-Wallis analysis of variance (P =.0035). Conclusion: Magnesium citrate reduces gastrointestinal transit times of activated charcoal stools when administered to children who receive activated charcoal for a toxic ingestion. Further study is needed to determine the clinical value of this reduction. [Sue Y-J, Woolf A, Shannon M: Efficacy of magnesium citrate cathartic in pediatric toxic ingestions. Ann Emerg Med October 1994;24:709-712.].