European Journal of Pediatrics

, Volume 169, Issue 6, pp 681–688 | Cite as

Accidental intakes of remedies from complementary and alternative medicine in children—analysis of data from the Swiss Toxicological Information Centre

  • Tycho Jan Zuzak
  • Christine Rauber-Lüthy
  • Ana Paula Simões-Wüst
Original Paper


The use of complementary and alternative medicine (CAM) in Switzerland is rather high, and therefore, the occurrence of accidental intakes of CAM remedies by children and associated intoxications is to be expected. In the present study, the inquiries to the Swiss Toxicological Information Centre that took place from 1998 until 2007 and concerned accidental, unintended intakes of CAM remedies by children were analysed. Inquiries for information were performed by concerned care-givers, physicians, pharmacists and others in case of acute accidental intake of CAM remedies. Feedbacks from physicians about paediatric patients with acute intoxication possibly associated with the accidental ingestion of CAM remedies were as well considered. During the study period, 3,158 accidental intakes of CAM remedies (1,015 of herbal and 2,143 of homeopathic remedies) were reported, corresponding to 8.6% of all reported accidental intakes of pharmaceutical products by children. No significant increase of the yearly number of accidental intakes of CAM remedies was detected during the study period. There was no accidental intake of CAM remedies leading to severe signs or symptoms. Concerning the herbal remedies, three intoxications of moderate and 28 of minor severity were reported. Nine children with intoxication from homeopathic remedies were reported, with minor symptoms only. All other accidental intakes of CAM remedies did not lead to intoxications and evolved without manifestations. The data show that accidental, unintended intake of CAM remedies happened in children, but developed mostly harmlessly. Comparing herbal with homeopathic remedies, accidental intakes with homeopathic remedies were more common, but intoxications associated with manifestations were observed more frequently with herbal remedies.


Complementary and alternative medicine Intoxication Homeopathy Herbal Children Accidental intakes 



Complementary and alternative medicine


Swiss Toxicological Information Centre


In-house computer-based and structured data recording and analysis system


  1. 1.
    Astin JA, Marie A, Pelletier KR et al (1998) A review of the incorporation of complementary and alternative medicine by mainstream physicians. Arch Intern Med 158:2303–2310CrossRefPubMedGoogle Scholar
  2. 2.
    Barnes J, Mills SY, Abbot NC et al (1998) Different standards for reporting ADRs to herbal remedies and conventional OTC medicines: face-to-face interviews with 515 users of herbal remedies. Br J Clin Pharmacol 45:496–500CrossRefPubMedGoogle Scholar
  3. 3.
    Cohen MH, Kemper KJ (2005) Complementary therapies in pediatrics: a legal perspective. Pediatrics 115:774–780CrossRefPubMedGoogle Scholar
  4. 4.
    Dantas F, Rampes H (2000) Do homeopathic medicines provoke adverse effects? A systematic review. Br Homeopath J 89(Suppl 1):S35–S38CrossRefPubMedGoogle Scholar
  5. 5.
    Eisenberg DM, Davis RB, Ettner SL et al (1998) Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey. JAMA 280:1569–1575CrossRefPubMedGoogle Scholar
  6. 6.
    Elmer GW, Lafferty WE, Tyree PT, Lind BK (2007) Potential interactions between complementary/alternative products and conventional medicines in a Medicare population. Ann Pharmacother 41:1617–1624CrossRefPubMedGoogle Scholar
  7. 7.
    Ernst E (1996) Risk-free homeopathy? Swiss Med Wkly 126:1677–1679Google Scholar
  8. 8.
    Ernst E (1998) Harmless herbs? A review of the recent literature. Am J Med 104:170–178CrossRefPubMedGoogle Scholar
  9. 9.
    Ernst E, Thompson Coon J (2001) Heavy metals in traditional Chinese medicines: a systematic review. Clin Pharmacol Ther 70:497–504CrossRefPubMedGoogle Scholar
  10. 10.
    Ernst E (2003) Serious adverse effects of unconventional therapies for children and adolescents: a systematic review of recent evidence. Eur J Pediatr 162:72–80PubMedGoogle Scholar
  11. 11.
    Guirguis M, Gossweiler B, Kupferschmidt H et al (1999) TOXI—a multifunctional system for poisons information and clinical toxicological data evaluation. J Toxicol Clin Toxicol 37:405–405Google Scholar
  12. 12.
    Karch FE, Lasagna L (1977) Toward the operational identification of adverse drug reactions. Clin Pharmacol Ther 21:247–254PubMedGoogle Scholar
  13. 13.
    Kupferschmidt H (2008) Intoxication in Switzerland. Annual report, 2007 of Swiss Toxicological Informations Centre. Schweizerische Aerztezeitung 2008:1906–1910Google Scholar
  14. 14.
    Kupferschmidt H, Reust H, Kupper J et al (2007) Intoxication in Switzerland. Schweiz Ärzteztg 88(48):2040–2044Google Scholar
  15. 15.
    Laengler A, Spix C, Seifert G et al (2008) Complementary and alternative treatment methods in children with cancer: a population-based retrospective survey on the prevalence of use in Germany. Eur J Cancer 44:2233–2240CrossRefPubMedGoogle Scholar
  16. 16.
    Meijerman I, Beijnen JH, Schellens JH (2006) Herb-drug interactions in oncology: focus on mechanisms of induction. The Oncologist 11:742–752CrossRefPubMedGoogle Scholar
  17. 17.
    Parson B, Dobbin M, Tibballs J (1997) Eucalyptus oil poisoning among young children: mechanisms of access and the potential for prevention. Aust N Z J Public Health 21:297–302CrossRefGoogle Scholar
  18. 18.
    Persson HE, Sjoberg GK, Haines JA et al (1998) Poisoning severity score. Grading of acute poisoning. J Toxicol Clin Toxicol 36:205–213CrossRefPubMedGoogle Scholar
  19. 19.
    Reznik M, Ozuah PO, Franco K et al (2002) Use of complementary therapy by adolescents with asthma. Arch Pediatr Adolesc Med 156:1042–1044PubMedGoogle Scholar
  20. 20.
    Shaw D, Leon C, Kolev S, Murray V (1997) Traditional remedies and food supplements. A 5-year toxicological study (1991–1995). Drug Saf 17:342–356CrossRefPubMedGoogle Scholar
  21. 21.
    Swiss Toxicological Information Centre, Switzerland (1998–2007) Annual Reports.
  22. 22.
    von Mach MA, Habermehl P, Zepp F, Weilemann LS (2006) Drug poisonings in childhood at a regional poisons unit. Klin Padiatr 218:31–33CrossRefGoogle Scholar
  23. 23.
    Zuzak TJ, Zuzak-Siegrist I, Simoes-Wust AP et al (2009) Use of complementary and alternative medicine by patients presenting to a paediatric Emergency Department. Eur J Pediatr 168:431–437CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Tycho Jan Zuzak
    • 1
    • 2
  • Christine Rauber-Lüthy
    • 3
  • Ana Paula Simões-Wüst
    • 4
  1. 1.Department of Pediatric Oncology and HaematologyUniversity Children’s Hospital EssenEssenGermany
  2. 2.University Children’s Hospital of ZurichZurichSwitzerland
  3. 3.Swiss Toxicological Information CentreZurichSwitzerland
  4. 4.Research DepartmentParacelsus-Hospital RichterswilRichterswilSwitzerland

Personalised recommendations