Optimizing Paediatric Paracetamol Dosing: Transitioning from Age-Based to Automated Weight-Based Calculations in Saudi Arabia

Abstract

Introduction: Paracetamol is one of the most commonly used over-the-counter (OTC) medications for managing conditions in paediatric patients. Objectives: Evaluate paediatric paracetamol dosing by age versus weight, and propose automated solutions for OTC dosing. Methods: A retrospective study compared weight-based (15mg/kg) to age-based dosing in children 0-13years of age. Results: A total of 352 paediatric patients were included, with a mean age of 5years, 4.8 months (SD=48 months) and a median weight of 16.9 kg (IQR:10.4 to 25.75).We observed that 71.59% of patients (n=252) are likely to be underdosed when using age-specific dosages rather than their actual weight. Conversely, 27.56% (n=97) could be overdosed, and only 0.85% (n=3) received an accurate dose. The discrepancies between the age-based and weight-based doses ranged from 1 mg to 928.5 mg per dose. We noted a correlation between the patient's weight and the variation in dose between the two different methods of dosing; r(350)=0.82, p<0.001. The regression was significant [F(1,350)=742.18, p<0.001], with 67.2% of the variability in dose difference explained by the patient's weight. The average difference in dose was 6.9 mg for every kilogram of the patient's weight. A linear regression analysis revealed that the patient's age was also a significant predictor of dose difference (F(1,350)=150.12, p<0.0001), with age explaining 29.8% of the variance. On average, the dose of paracetamol differed by 1.5 mg for each additional month of patient age (p<0.001). Expected impact: To optimise the dosing of OTC medication and enhance safety, we propose the use of supervised machine learning with Saudi growth charts, and the integration of a weight-based dosing calculator into the ‘Sehaty’ app.

Keywords

• Artificial Intelligence
• Body Weight
• Drug Dosage Calculations
• Medication Errors
• Paracetamol (Acetaminophen)
• Patient Safety