For lead poisoning with blood levels greater than 45 µg/dL, what is the preferred chelation therapy?

In cases of lead poisoning with blood lead levels exceeding 45 µg/dL, the preferred chelation therapy is succimer. Succimer is an oral chelating agent that is particularly effective in treating pediatric lead poisoning due to its safety profile and ability to mobilize lead from the bones and soft tissues where it may be sequestered.

Using succimer is advantageous because it has a favorable side effect profile compared to other chelation agents. It is also the first-line treatment for lead toxicity in children, aligning with recommendations from authoritative medical guidelines. The ability to administer succimer orally makes it more convenient for outpatient management, which is especially important in pediatrics where ease of administration can enhance compliance with treatment.

While other agents like EDTA and dimercaprol can also be used in chelation therapy for lead poisoning, they are typically reserved for more severe cases or specific scenarios. EDTA is often used in cases with acute severe toxicity requiring parenteral therapy, and dimercaprol is less commonly indicated due to its potential side effects and the requirement for intramuscular injection. Deferoxamine is primarily used for iron chelation, making it irrelevant in the context of lead poisoning.

Therefore, succimer stands out as the preferred choice