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Underdosing of acetaminophen by parents
1Department of Emergency Medicine, Children's Hospital of Philadelphia, PA.
Insights
Many parents underdose young children with acetaminophen for fever. This common practice, especially in younger, lighter children, can lead to ineffective fever management. Healthcare providers should clarify dosing instructions.
Area of Science:
- Pediatrics
- Pharmacology
- Public Health
Background:
- Fever is a common symptom in young children.
- Acetaminophen is a widely used antipyretic medication for pediatric fever.
- Accurate dosing is crucial for effective and safe fever management.
Purpose of the Study:
- To investigate parental management of fever in young children.
- To assess the accuracy of acetaminophen dosing by parents.
- To identify factors contributing to acetaminophen underdosing.
Main Methods:
- Survey of parents (n=96) of young children presenting with fever at an inner-city clinic.
- Inquiry into their methods of fever management, specifically acetaminophen administration.
- Analysis of reported doses and comparison with recommended pediatric dosages.
Main Results:
- 92% of parents administered acetaminophen for fever.
- 67% of those administering acetaminophen gave less than the recommended dose (10-15 mg/kg).
- Incorrect use of measuring devices led to significant underdosing (2.3 +/- 1.3 mg/kg) in 26% of elixir users.
Conclusions:
- Parental underdosing of acetaminophen in young children is prevalent.
- Inaccurate measurement of liquid preparations is a key factor in underdosing.
- Healthcare professionals must actively inquire about and educate parents on correct acetaminophen dosing for effective fever reduction.
Abstract:
The parents of 96 young children seen in an inner-city walk-in clinic for perceived or measured "fever" were asked about their management of the symptom. Eighty-eight (92%) administered acetaminophen, and of these, 67% gave less than the usual recommended dose of 10 to 15 mg/kg per dose. Underdosing was most commonly noted in the younger, lighter patient population. Of the parents who gave an acetaminophen elixer preparation (160 mg/5 mL), 26% measured the dose with the 0.8-mL dropper intended for use with the infant drops preparation (80 mg/0.8 mL), resulting in significant underdosing of acetaminophen (2.3 +/- 1.3 mg/kg per dose). Health care professionals should specifically inquire about the details of acetaminophen administration when discussing antipyresis with parents.