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Is prescribing paracetamol 'pro re nata' acceptable?
A C Penna1, K P Dawson, C M Penna
1Department of Paediatrics, Westmead Hospital, New South Wales, Australia.
Journal of Paediatrics and Child Health
|April 1, 1993
Summary
Paracetamol prescribing patterns in children show a risk of overdose. The common "as needed" (p.r.n.) regimen for fever and pain can lead to hazardous doses exceeding 90 mg/kg per 24 hours.
Area of Science:
- Pediatric Pharmacology
- Hospital Pharmacy Practice
Background:
- Paracetamol is a common analgesic and antipyretic in pediatric care.
- Understanding its prescribing patterns is crucial for patient safety.
Purpose of the Study:
- To evaluate paracetamol prescribing practices in a general hospital's pediatric department.
- To identify potential risks associated with common dosing regimens.
Main Methods:
- Retrospective audit of 299 pediatric inpatient case records.
- Analysis of paracetamol indication, dosage, and administration frequency.
Main Results:
- Paracetamol was prescribed for 190 (63.5%) of the sampled children.
- Fever and post-operative pain were primary indications.
- A 4-hourly 'as needed' (p.r.n.) regimen was most frequent, posing overdose risk.
- 74% of children had a prescription with potential for exceeding 90 mg/kg/24h; 13.6% actually received this dose.
Conclusions:
- The 'as needed' (p.r.n.) paracetamol regimen in pediatric inpatients carries a significant risk of accidental overdose.
- Pediatric dosing protocols for paracetamol require review to prevent potentially hazardous administration.