Children at risk as GPs prescribe high doses of paracetamol

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AS many as one in four toddlers are being prescribed too high a dose of paracetamol by doctors, putting them at risk of liver damage, a Scottish study suggests.

Researchers in Aberdeen and Edinburgh found that many prescriptions issued by GPs for the commonly used drug either exceed the recommended dose for small children, or are not strong enough for older youngsters.

The problem could be made worse by parents giving their children extra paracetamol contained in medicines bought from chemists.

The researchers, writing in the British Journal of Clinical Pharmacology, said doctors needed to be more careful in following guidelines when prescribing the drug to children.

Paracetamol is the most commonly used medicine taken to manage pain and fever, with 80 per cent of children in the UK having at least one dose before they are six months old.

But judging how much to give a child is difficult because age and weight have to be taken into account.

This means that doctors should take advice from documents such as the British National Formulary for Children (BNFc), which gives guidance on prescribing issues.

The researchers, from Aberdeen University and Edinburgh University, set out to see how well GPs were following guidelines when giving paracetamol to children.

They focused on the Scottish Practice Team Information database from 2006, containing data on almost 36,000 children up to the age of 12.

Out of this group, 2,761 had received 4,423 prescriptions for paracetamol.

Overall, almost one in 20 of these youngsters had been given an excessive dose during this period.

Looking at children under the age of three, those given too high a dose increased to one in four. The researchers also found that at the same time, around a quarter of older children - those aged six to 12 - were given too low a dose.

The findings raise concerns because not giving a high enough dose could mean pain is not relieved, while giving too much can damage the liver.

Worryingly, one-in-eight prescriptions failed to include any information on dosage for the patient at all.

Senior researcher James McLay said: "This is the first study to describe the patterns of paracetamol prescribing by primary care physicians in the community, and it is worrying to discover that just over half of the prescriptions failed to comply with current BNFc recommendations."

The researcher said health staff had a vital role in helping people use paracetamol safely.

Dr Dean Marshall, chairman of the British Medical Association (BMA) Scottish GPs Committee, said: "While it is important that GPs are aware of the guidelines, it is important that GPs take responsibility for their prescribing which is based on the assessment of the patient as an individual."