A COMPARISON OF AGE-BANDED AND WEIGHT-BASED ORAL PARACETAMOL DOSING IN HOSPITALISED CHILDREN.

Published Date: 01st June 2023

Publication Authors: Wright K

Abstract: The British National Formulary for Children contains two dosing strategies for oral paracetamol: age-banded and weightbased. Weight-based is used in our hospital. This study compares dosing strategies in inpatients. Retrospective analysis over 4 years was undertaken in a single tertiary paediatric hospital. Data was collected from electronic patient records. Patients 3 months to 18 years were included. One measurement per admission was allowed. This was compared the Health Survey England (HSE) and National Child Measurement Programme (NCMP). Of 161150 admissions it was possible to match weight to 115466 (58287 patients) and height to 18806 (4892 patients). Of 95598 paracetamol prescriptions, doses <10mg/kg occurred in 5427(5.7%) prescriptions and doses >20mg/kg in 691(0.72%) prescriptions. Of the doses <10mg/kg, 1003 were in patients >66.7kg. Applying age-banded doses to all admissions would result in doses <10mg/kg in 20748 (18%) of admissions (13111 patients) and doses >20 mg/kg would occur in 4420 (3.8%) of admissions (2054 patients), most commonly in teenagers. Weight-based dosing (maximum 1g/ dose) would lead to doses <10mg/kg in 931 admissions (395 patients). The potential for inadequate or excessive paracetamol dosing is greater with age-banded doses compared with weightbased doses in hospitalised children. Compared to NCMP and HSE data, obesity is more common in hospitalised children across all ages. Compared to NCMP data, underweight is more common in reception aged hospitalised children but not in year 6. Therefore, atypical body weights are more common in hospitalised children than the general population. A higher proportion of low body weight is seen in young children and teenagers. As a result, age-banded dosing should not be used in hospitalised children.

Wright, K; Et al. (2023). A COMPARISON OF AGE-BANDED AND WEIGHT-BASED ORAL PARACETAMOL DOSING IN HOSPITALISED CHILDREN. Archives of Disease in Childhood. 108(6), p... [Online]. Available at: https://dx.doi.org/10.1136/archdischild-2023-ESDPPP.14 [Accessed 3 April 2025].

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