Dosing and Antipyretic Efficacy of Oral Acetaminophen in Children

Abstract Background A standardized approach to dosing acetaminophen in pediatric populations was published in 1983. That review proposed specific weight-related dosing for infants and children weighing 6 through 95 lb and an age-based schedule for children aged Objective This article reviewed published and unpublished pediatric antipyretic data to provide a critical assessment of the 10–15-mg/kg oral dose and the current pediatric oral dosing schedules for acetaminophen. Methods Published literature and unpublished clinical trials that evaluated the antipyretic efficacy of acetaminophen in children were reviewed. The PubMed database was searched using the term acetaminophen or paracetamol, with study criteria limited to randomized, controlled trials; oral dosing; patient age Results Thirteen unpublished trials enrolled 705 children to receive an oral dose of 10–15 mg/kg of acetaminophen. This dose resulted in a rapid onset of temperature reduction, with a maximum temperature decrement of ~3 hours following administration. Results from 40 published clinical trials in which 2332 children received oral acetaminophen for fever support these findings. The most common adverse events reported in any of the reported studies were gastrointestinal in nature and generally mild in intensity. Conclusions Data support the recommended 10–15-mg/kg oral dose and demonstrate that the age and weight schedules for over-the-counter acetaminophen proposed in 1983 remain appropriate.