N-Acetyl Cysteine in Rodenticide Poisoning: A Systematic Review and Meta-Analysis

source extracted confidence: high 2026-04-09
#acetylcysteine #humans #prospective-studies #retrospective-studies #rodenticides

N-Acetyl Cysteine in Rodenticide Poisoning: A Systematic Review and Meta-Analysis

Rashid et al., 2022 | Curr Rev Clin Exp Pharmacol | Meta Analysis

Citation

Rashid Muhammed, Chandran Viji Pulikkel, ... Thunga Girish. N-Acetyl Cysteine in Rodenticide Poisoning: A Systematic Review and Meta-Analysis. Curr Rev Clin Exp Pharmacol. 2022;17(3):192-204. doi:10.2174/2772432816666210825102726

Abstract

BACKGROUND: Treatment with N-Acetyl Cysteine (NAC) in rodenticide poisoning has not been well established due to mixed study results and insufficient evidence. This review aimed to summarize the clinical benefits of NAC in the management of rodenticide poisoning. METHODS: This review follows the PICOS framework and the PRISMA guidelines. Pub- Med/MEDLINE, Scopus, and the Cochrane library were searched to identify the published literature from inception to September 2020, and a reference search was performed for additional relevant studies. The English language studies addressing the use of NAC in rodenticide poisoning were considered for the review. We considered all experimental and observational studies due to the insufficient number of interventional studies. RESULTS: Ten studies (two RCTs, four observational, and four descriptive) out of 2,178 studies with 492 participants were considered for the review. Only six studies (two RCTs, one prospective, and three retrospective studies) reported recovery and mortality. Pooled results of RCTs (n=2) showed a significant recovery rate (Odds Ratio [OR]: 3.97; 95% Confidence Interval [CI]:1.69-9.30), whereas summary estimates of prospective and retrospective studies recorded a non-significant effect. Metaanalysis of RCTs (OR: 0.25; 95% CI: 0.11-0.59; n=2) and retrospective studies (OR: 0.34; 95% CI: 0.15-0.78; n=3) showed a significant reduction in mortality, whereas pooled analysis of prospective studies recorded a non-significant effect. A significant reduction in intubation or ventilation (OR: 0.25; 95% CI: 0.11-0.60; 2 RCTs) and a non-significant (P=0.41) difference in duration of hospitalization was observed with NAC when compared to the non-NAC treated group. The quality of the included studies appeared to be moderate to high. CONCLUSION: Our findings indicate that NAC showed better survival and lower mortality rate when compared to non-NAC treated group; hence NAC can be considered for the management of rodenticide poisoning.

Key Findings

Ten studies (two RCTs, four observational, and four descriptive) out of 2,178 studies with 492 participants were considered for the review. Only six studies (two RCTs, one prospective, and three retrospective studies) reported recovery and mortality. Pooled results of RCTs (n=2) showed a significant recovery rate (Odds Ratio [OR]: 3.97; 95% Confidence Interval [CI]:1.69-9.30), whereas summary estimates of prospective and retrospective studies recorded a non-significant effect. Metaanalysis of RC

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 2
Age Range See abstract
Condition See abstract

MeSH Terms

  • Acetylcysteine
  • Humans
  • Prospective Studies
  • Retrospective Studies
  • Rodenticides

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: zinc

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09