Paracetamol use (and/or misuse) in children in Enugu, South-East, Nigeria

BMC Pediatrics

Ikenna K Ndu²  Christopher B Eke¹  Agozie C Ubesie¹  Josephat M Chinawa¹  Herbert A Obu¹ 

[1] Department of Paediatrics, College of Medicine, University of Nigeria, Enugu Campus & University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, 400001, Nigeria;Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria

关键词: Caregivers;    Children;    Misuse;    Use;    Paracetamol;   

Others  :  1170729
DOI  :  10.1186/1471-2431-12-103

 received in 2012-03-08, accepted in 2012-07-19,  发布年份 2012

【 摘 要 】

Background

Paracetamol (also known as acetaminophen) is the commonest available analgesic and anti-pyretic. It is readily accessed from pharmacy, patent medicine and provision shops as over the counter drug making it a potential drug of abuse, especially in children. We sought to find its use and/or misuse in children seen at the paediatric outpatient clinic of the University of Nigeria Teaching Hospital (UNTH) Ituku-Ozalla, Enugu.

Objective

To determine the dosage, formulation, and frequency of paracetamol administration to children by caregivers and factors associated with its use and/or misuse.

Method

An observational prospective study involving 231 children and their caregivers seen at the paediatric outpatient clinic of the University of Nigeria Teaching Hospital, Ituku - Ozalla, Enugu between June and November 2011 was undertaken. Data on paracetamol use before presentation to the clinic, in addition to demographic and other data were obtained from the caregivers using a structured questionnaire. Ethical consent for the study was obtained from the Hospital Ethics and Research Committee and informed consent was further obtained from the caregivers of the children.

Results

A total of 231 children aged six weeks to 16 years and their caregivers participated in this study. The mean ages of the children and their caregivers were 3.8 and 33.9 years, respectively. One hundred and thirty three of the children studied were males while 98 were females. Most of the children (75.6%) received paracetamol at home before presenting. Paracetamol tablet alone or in combination with the syrup was mostly used (60%) and this observation was made across all age groups. The commonest reason for using paracetamol tablet instead of the syrup was that it was more effective. Most caregivers relied on past experience (71.2%) rather than on enclosed information leaflet to decide the appropriate dosage. Half of the children also received other medications, mainly anti-malarials and antibiotics.

Conclusions

Paracetamol was commonly given to children on “self prescription” basis and the tablet formulation was most frequently used, with the possibility of misuse and overdose. Caregivers need to be educated on age-appropriate formulations which are less likely to lead to overdose.

【 授权许可】

   
2012 Obu et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Barry HR: Chemical and drug poisoning. In Nelson textbook of pediatrics. 18th edition. Edited by Nelson WE, Behrmanv RE, Kliegman RM, Arvin AM. W.B. Saunders Company, Philadelphia; 2010:2013.
• [2]Suzan SM: Toxicology. In Pediatrics: just the facts. 1st edition. Edited by Thomas G, Wayne F, Robert RT. McGraw-Hill, Boston; 2005:71.
• [3]Utpal KS, Ramesh KP: Acetaminophen poisoning. In Principles of pediatric and neonatal emergencies. 2nd edition. Edited by Sachdev HPS, Panna C, Arvind B, Krishan C, Siddarth R, Ramesh KP. Jaypee Brothers, New Delhi; 2004:436.
• [4]Park A: The FDA's painkiller warning: how to avoid taking too much. Time. , ; . Available at: http://www.time.com/time/health/article/0,8599,1572012,00.html webcite December 20, 2006; Accessed January 10, 2007
• [5]Graham GG, Scott KF: Mechanism of action of paracetamol. Am J Ther 2005, 12:46-55.
• [6]: FDA May Restrict Acetaminophen. , ; . Webmd.com. 2009-07-01. http://www.webmd.com/pain- management/news/20090701/fda-may-restrict- acetaminophen webcite
• [7]Per L, Salvi H, Tanja H: Childhood illnesses and the use of paracetamol: a qualitative study of parents’ management of common childhood illnesses. Fam Pract 2012, 20:717-723.
• [8]Eran K, Revital G, Deene RZ, Matitiahu B: Repeated Supratherapeutic Dose of Paracetamol in children: A literature Review and suggested clinical approach. , ; .
• [9]PharmWeb. Paracetamol Information Center: Paracetamol Dosage. , ; . Copyright©1994-2012. [Online]. Available from: http://www.pharmwebo.net/pwmirror/pwy/paracetamol/pharmwebpic.html webcite. (Accessed May 10, 2012)
• [10]Grandins L, Gazarian M: Promoting Safe Use Of Paracetamol In Children. J Pharm Prect Res 2006, 36:297-30.
• [11]Sheen CL, Dillon JF, Batemen DN, Simpson KJ, Macdonald TM: Paracetamol toxicity: epidemiology, prevention and costs to the health‒care system. QJM 2002, 95:609-19.
• [12]Meremiku M, Oyo H: Paracetamol for treating fever in children. Cochrane Database Syst Rev 2002, 2:CD003676.
• [13]Thomas JS, Prescott LF: Liver damage and impaired glucose tolerance after Paracetamol overdose. Br Med J 1966, 2:506-7.
• [14]Abbott FA, Fraser MP: Use and Abuse of over the counter analgesic agents. Psychiatry Neurosci 1988, 23:13-14.
• [15]Hundie K, Debella A, Hymete A: Comparative quality evaluation of some brands of paracetamol tablets, suppositories and syrup. Ethiopian Pharmaceutical journal 2008, 26:59-64.
• [16]Remsing J, Mein S: Rectal and parenteral paracetamol,and paracetamol in combination with NSAIDs for post operative anaesthasia. Br J Anaesth 2002, 88:215-26.
• [17]Australian Broadcasting Cooperation: The 7.30 Report. , ; . TV Program transcript at http://www.abc.net.au/7.30/content/2002/5719324.htm webcite
• [18]Ajayi IO, Falade CO: Pre-hospital treatment of febrile illness in children attending the General Outpatients Clinic, University College Hospital, Ibadan, Nigeria. Afr J Med Med Sci 2006, 35(1):85-91.