Acetaminophen and ibuprofen dosing by parents

Background: Acetaminophen and ibuprofen are two of the most commonly used m edications in children. It is our experience that parents often misdose the se medications. Misdosing may lead to unintended toxicity or inadequate sym ptomatic improvement. There are limited data on the extent of misdosing of these antipyretics, We sought to determine the prevalence of and risk facto rs for inaccurate dosing by parents seeking care for their children in the emergency department (ED). Methods A cross-sectional observational study was performed in an urban aca demic pediatric ED. Two hundred patients 10 years of age and younger who we re given a known dose of acetaminophen or ibuprofen in the 24 hours prior t o the ED visit were enrolled. The treating physician completed a questionna ire for each patient. Caregivers were asked about quantity and frequency of antipyretic use prior to the ED visit, the Source: of information used to determine dosage, and which factor (eg, age, sex, height, weight, height of fever, severity of illness) they considered most important in determining the correct dosage of medication. Doses of 10 to 15 mg/kg for acetaminophen and 5 to 10 mg/kg for ibuprofen were considered accurate, Results: Overall, 51% of patients received an inaccurate dose of medication , including 62% of patients given acetaminophen: and 26% of patients given ibuprofen, Infants < 1 year old were more likely to receive an inaccurate d ose (RR 1.40, P < 0.04, 95% CI = 1.06-1.86). Caregivers who stated that med ication dosage was based on weight were less likely to give an inaccurate d ose of medication (RR 0.71, P < 0.03, 95% CI = 0.52-0.97). Conclusions: Over half of the caregivers surveyed gave an inaccurate dose o f acetaminophen or ibuprofen, particularly to infants. Caregivers who repor ted that antipyretic dosage was based on weight were less likely to misdose medication, suggesting a valuable role for patient education.