One in four toddlers given too much paracetamol

One in four children under the age of three are being given too much of the painkiller paracetamol, research suggests.

A study of children's medical records found more than half of prescriptions issued by GPs got the recommended dose wrong. Although rare, over-dosing with paracetamol can result in liver damage, while under-dosing can leave a child in pain.

Paracetamol is the most frequently used single medicine for treating fever and pain in the UK. Four out of five infants have had at least one dose of the drug before they are six months old, the researchers said.

In the study, researchers from Aberdeen and Edinburgh Universities scrutinised prescriptions for 35,839 Scottish children aged between 0 and 12 years old in 2006.

Of these, 2,761 children had been issued with 4,423 prescriptions for paracetamol.

On more than half of the prescriptions the dose was either too high or too low, with nearly one in 20 children given a dose which was described as "excessive."

However, this figure rose to one in four when it came to toddlers aged three years old and under.

The researchers also found that around a quarter of children aged between six and 12 had received less than the recommended dose.

And one in eight prescriptions failed to include any dosage instructions at all.

Writing in the British Journal of Clinical Pharmacology, the study authors said that calculating the correct dose of paracetamol for a child was "not straightforward."

"Getting the dose right can become even more complicated when parents also give their children additional paracetamol that they have bought over the counter," said Dr James McLay, from the department of medicine at the University of Aberdeen.

Dr McLay also said it was worrying to discover that more than half of the prescriptions failed to comply with the dosage recommendations set out in British National Formulary for Children (BNFc), and although the study was conducted in Scotland, the results were relevant wherever doctors write prescriptions for paracetamol.

He said: "We know from other studies that around half of parents do not understand official dosage recommendations for medicines such as paracetamol, and not taking care over dosing instructions can leave parents in a state of confusion, or strengthen the public perception that paracetamol is harmless."

This article was published on Thu 19 May 2011