George Mathew, Phelps Mitch A, Kitzmiller Joseph P
Southshore Hospital, Weymouth, MA, USA.
Clin Pediatr (Phila). 2012 Nov;51(11):1030-1. doi: 10.1177/0009922812456592. Epub 2012 Aug 13.
Acetaminophen-associated liver toxicity remains a serious concern, but guidance regarding dose selection is ambiguous, and the literature describing acetaminophen efficacy and toxicity in pediatrics is limited. Clinical investigation and reporting are needed. This study investigates caregiver satisfaction with 2 commonly prescribed dose levels. This nonrandomized, open-label, outpatient study included 37 moderately febrile pediatric patients prescribed acetaminophen at either 10 or 15 mg/kg every 4 hours. Patient caregivers indicated how well the acetaminophen reduced fever by completing a 5-point Likert scale. A 2-sample t test determined whether a statistically significant difference in satisfaction scores existed. Sufficient statistical power was achieved, and the mean satisfaction scores for both groups were not significantly different. Although further studies using more precise and objective end points are needed to provide optimal evidence-based guidance for acetaminophen pediatric dose selection, the findings in this study suggest that prescribers should consider a starting dose of only 10 mg/kg for moderately febrile pediatric patients.
对乙酰氨基酚相关的肝毒性仍然是一个严重问题,但关于剂量选择的指导并不明确,且描述对乙酰氨基酚在儿科疗效和毒性的文献有限。需要进行临床研究和报告。本研究调查了照顾者对两种常用处方剂量水平的满意度。这项非随机、开放标签的门诊研究纳入了37名中度发热的儿科患者,每4小时给予10或15mg/kg的对乙酰氨基酚。患者照顾者通过完成一个5级李克特量表来表明对乙酰氨基酚降低体温的效果如何。采用双样本t检验来确定满意度评分是否存在统计学上的显著差异。获得了足够的统计效力,两组的平均满意度评分没有显著差异。尽管需要使用更精确和客观的终点进行进一步研究,以为对乙酰氨基酚儿科剂量选择提供最佳的循证指导,但本研究结果表明,对于中度发热的儿科患者,开处方者应考虑起始剂量仅为10mg/kg。