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Teaspoons Behind Many Child Drug-Dosing Errors

Experts recommend medications be administered in milliliters only

WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

MONDAY, July 14, 2014 (HealthDay News) -- Using a teaspoon or tablespoon to administer kids' medications can often lead to medication dosing errors, a new study reports.

Teaspoon- or tablespoon-based medicine instructions doubled a parent's chances of incorrectly measuring the intended dosage, and also doubled the risk they would not accurately follow the doctor's prescription, the study authors found.

"A move to a milliliter preference for dosing instructions for liquid medications could reduce parent confusion and decrease medication errors, especially for groups at risk for making errors, such as those with low health literacy and non-English speakers," said the study's lead author Dr. Shonna Yin, an assistant professor of pediatrics at NYU School of Medicine in New York City.

Findings from the study were published online July 14 and in the August print issue of Pediatrics.

More than 10,000 annual calls to poison centers occur because the wrong dose of oral liquid medications was given to a child, according to background information included in the study.

A number of groups have suggested that pediatricians and pharmacists switch to milliliter dosing for young patients, including the American Academy of Pediatrics, the U.S. Centers for Disease Control and Prevention, and the Institute for Safe Medication Practices.

To test whether this would help, Yin and her colleagues observed 287 parents providing medicine to their children.

The investigators found that, overall, 39 percent of parents incorrectly measured the dose they intended and, ultimately, 41 percent made an error in measuring what their doctor had prescribed.

Parents using teaspoon or tablespoon measurements were 2.3 times more likely to pour the wrong dose and 1.9 times more likely to not accurately follow the prescription, the researchers said.

Nearly one-third of the parents given instructions with teaspoon or tablespoon doses reached for a kitchen spoon, which made them 2.5 times more likely to get the dose wrong, said co-author Dr. Ian Paul, associate vice chair for research at the Penn State College of Medicine department of pediatrics.

"When you look at a kitchen spoon, the amount that will actually sit in the spoon is less likely to be exactly what it's meant to be," Paul said. "You're less likely to get the right amount onto that spoon and then deliver it to a child's mouth."

The inaccuracy of kitchen spoons becomes even more worrisome given that drugs are prescribed to children based on their weight, to make sure they are receiving a precise dose, said Heather Free, a pharmacist in Washington, D.C., and spokeswoman for the American Pharmacists Association.

Kids are more sensitive than adults to many drugs, and getting the dose even slightly wrong can lead to problems.

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