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British National Formulary for Children: the risk of inappropriate paracetamol prescribing
  1. Sally Eyers1,2,
  2. James Fingleton1,
  3. Ashley Eastwood1,2,
  4. Kyle Perrin1,3,
  5. Richard Beasley1,3,4
  1. 1Medical Research Institute of New Zealand, Wellington, New Zealand
  2. 2University of Otago Wellington, Wellington, New Zealand
  3. 3Capital & Coast District Health Board, Wellington, New Zealand
  4. 4University of Southampton, Southampton, UK
  1. Correspondence to Dr Sally Eyers, Medical Research Institute of New Zealand, Private Bag 7902, Newtown, Wellington 6242, New Zealand; sally.eyers{at}mrinz.ac.nz

Abstract

Background Paracetamol is the most commonly prescribed medicine for children. Age-based dosing guidelines can lead to inappropriate dosing.

Methods A review of age-based guidelines for paracetamol in the British National Formulary for Children (BNFC) 2011–2012 was undertaken. Single and cumulative daily doses of paracetamol for boys and girls at 9th, 50th and 91st centiles for weight were calculated for the age groups 1–3 months, 3–12 months, 1–6 years and 6–12 years.

Results For children at the 9th centile, aged 3 months and above, doses were above recommended single and cumulative daily dose therapeutic limits when given the highest dose specified for their age. For children at the 91st centile at all ages, doses were below recommended single and cumulative daily dose therapeutic limits when given the lowest dose specified for their age.

Conclusions Underweight and overweight children are at risk of inappropriate paracetamol administration based on BNFC age-based dosing instructions.

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Footnotes

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Contributors SE developed the concept for the study. SE, AE, KP and RB were involved with study design and data analysis. SE, AE, KP and RB were involved with the drafting of the manuscript. SE, JF, KP and RB were involved with manuscript revision. JF was involved with figure design and data-checking. SE is the guarantor.