Comprehensive Toxicology Drug Screening Data in a Pediatric Population

The paper by Kyle et al. (1) intrigued us to analyze our pediatric experience with comprehensive drug screens from our hospital and many area hospitals for which we serve as a referral laboratory. Similar to Kyle et al. we use a combination of enzyme immunoassays and gas chromatography-mass spectrometry (GC-MS) from Agilent Technologies (Palo Alto, CA) for comprehensive drug screens. We also frequently use Varian Inc. (Palo Alto, CA) thin-layer chromatography system for drug screening. Other tests in our comprehensive drug screen include salicylate screen by Trinder’s reagent and volatile screen by microdiffusion. If microdiffusion is positive, confirmation of acetone, ethanol, isopropanol, and methanol is done by gas chromatography with flame ionization detector. Enzyme immunoassays for amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine metabolites, methadone, opiates, phencyclidine, and propoxyphene are by Beckman-Coulter Inc. (Brea, CA). In 2 yrs, 2002 and 2003, we screened 1248 samples for comprehensive drug screens. Based on age, we divided our data in three groups (<6, 6– <12, and 12– <18 years). These groups constituted 40, 16, and 44%, respectively. As reported by Kyle et al., our smallest group was also the 6– <12-yr-olds. Unlike Kyle et al. we analyzed the drug data for different age groups and looked at the differences in these age groups. Table 1 summarizes the immunoassay data on drugs of abuse. The major difference between Kyle et al. and our data was a significantly higher rate of benzodiazepines and cannabinoids in our pediatric population. This higher rate of benzodiazepine positives in our population may be due to their frequent use in our hospital or may be due to methodological