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Potential medication dosing errors in outpatient pediatrics.

Heather A McPhillips¹, Christopher J Stille, David Smith

¹Department of Pediatrics and Epidemiology, University of Washington, and the Center for Health Studies, Group Health Cooperative, Seattle, Washington, 98105, USA. heather.mcphillips@seattlechildrens.org

The Journal of Pediatrics

|December 17, 2005

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Approximately 15% of children receive medications with potential dosing errors, including overdoses and underdoses. Further research is needed to understand the clinical impact and develop prevention strategies for pediatric medication safety.

Area of Science:

Pediatric Pharmacology
Medication Safety
Health Services Research

Background:

Medication dosing errors in children can lead to adverse health outcomes.
Accurate medication dispensing is crucial for pediatric patient safety.

Purpose of the Study:

To determine the prevalence of potential medication dosing errors in children.
To assess dosing errors for 22 common pediatric medications.

Main Methods:

Analysis of automated pharmacy data from 3 health maintenance organizations (HMOs).
Inclusion of 1933 pediatric subjects with new dispensing prescriptions.
Comparison of error rates between paper and electronic prescription systems.

Main Results:

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15% of children received medications with potential dosing errors (8% overdose, 7% underdose).
Children under 35 kg had only 67% of doses within recommended ranges.
Analgesics were most frequently overdosed (15%), while antiepileptics were most underdosed (20%).
Electronic prescribing did not reduce error rates.

Conclusions:

Potential medication dosing errors are common in outpatient pediatric settings.
Further studies are required to evaluate the clinical significance of these errors.
Effective strategies for preventing pediatric medication dosing errors need to be developed.