Table 1.
Clinical efficacy data of the main antidotes used in the management of Amanita phalloides poisoning in humans. Patient survival rates are associated with various drug classes after multidimensional statistical analysis.
| Empiric Therapeutic Strategy | Molecules | Putative Mechanism of Action | Associated Mortality Rate (11.6% Average Mortality) | References |
|---|---|---|---|---|
| First-line | Silibinin (alone or in combination) (n = 624) |
Inhibitor of the OATP1B3 transporter Antioxidant effectsAnti-inflammatory effects Tissue repair |
5.6% | [39,41] |
| N-acetyl-cysteine (n = 192) |
Antioxidant effects | 6.8% | ||
| Ceftazidime (combined with silibinin) Positive impact on a small number of patients (n = 12); interest to be demonstrated on larger samples |
OATP1B3 transporter inhibitor | 0% | ||
|
Second-line If first-line treatments are not available |
Benzylpenicillin alone or in combination (n = 1411) |
10.7% | ||
|
Interest still to be demonstrated No positive impact on care or deleterious impact on patient survival observed in a small number of patients |
Vitamin E (n = 25) | Antioxidant effects | 40% | |
| Vitamin C (n = 60), cimetidine (n = 21), thioctic acid (n = 450) | 12–20.3% | |||
| Gentamycin, neomycin, streptomycin, vancomycin, clindamycin (n = 63 in the entire group) | Unknown | |||
| Insulin + growth hormone (n = 69), insulin + glucagon (n = 128) | Stimulation of the hepatic metabolism | 16% | ||
| Steroids (n = 459) | Anti-inflammatory |