Amatoxin poisoning treatment decision-making: pharmaco-therapeutic clinical strategy assessment using multidimensional multivariate statistic analysis

Toxicon. 2010 Jun 15;55(7):1338-45. doi: 10.1016/j.toxicon.2010.02.005. Epub 2010 Feb 10.


Ninety percent of fatal higher fungus poisoning is due to amatoxin-containing mushroom species. In addition to absence of antidote, no chemotherapeutic consensus was reported. The aim of the present study is to perform a retrospective multidimensional multivariate statistic analysis of 2110 amatoxin poisoning clinical cases, in order to optimize therapeutic decision-making. Our results allowed to classify drugs as a function of their influence on one major parameter: patient survival. Active principles were classified as first intention, second intention, adjuvant or controversial pharmaco-therapeutic clinical intervention. We conclude that (1) retrospective multidimensional multivariate statistic analysis of complex clinical dataset might help future therapeutic decision-making and (2) drugs such as silybin, N-acetylcystein and putatively ceftazidime are clearly associated, in amatoxin poisoning context, with higher level of patient survival.

MeSH terms

  • Acetylcysteine / therapeutic use
  • Algorithms
  • Amanitins / poisoning*
  • Anti-Bacterial Agents / therapeutic use
  • Antioxidants / therapeutic use
  • Ceftazidime / therapeutic use
  • Databases, Factual
  • Decision Making
  • Decision Theory*
  • Factor Analysis, Statistical
  • Humans
  • Multivariate Analysis
  • Mushroom Poisoning / drug therapy
  • Mushroom Poisoning / therapy*
  • Retrospective Studies
  • Silybin
  • Silymarin / therapeutic use
  • Survival
  • Survival Rate


  • Amanitins
  • Anti-Bacterial Agents
  • Antioxidants
  • Silymarin
  • Silybin
  • amatoxin
  • Ceftazidime
  • Acetylcysteine