We appreciate the comments offered by Isbister and colleagues, as well as the opportunity to clarify our article. The intent of our study was to characterize acetaminophen overdose in a whole pediatric population, not certain age groups. Because of recent literature regarding hepatotoxicity resulting from intentional "supratherapeutic" dosing in children and adults,1- 4 we chose to stratify our population by intent to evaluate our experience relative to this concern. We acknowledged that the number of subjects with hepatotoxicity limited multivariate analysis (age and intent). Our data verified the suspicion that overdose in 6- to 10-year-olds was uncommon; there were only two 7-year-olds with unintentional, nontoxic acetaminophen ingestion. This small number would not have significantly changed our results if we had compared the age groups as suggested by Isbister et al.
Alander SW, Dowd MD, Bratton SL, Kearns GL. Pediatric Acetaminophen Poisoning—Reply. Arch Pediatr Adolesc Med. 2001;155(3):418. doi:10.1001/archpedi.155.3.417