Alise D E de Groot, Marijke A J van der Wagt, Nieko C Punt, Daan J Touw, Henkjan J Verkade, Paola Mian
{"title":"儿童扑热息痛负荷剂量：一项回顾性研究。","authors":"Alise D E de Groot, Marijke A J van der Wagt, Nieko C Punt, Daan J Touw, Henkjan J Verkade, Paola Mian","doi":"10.1136/ejhpharm-2025-004496","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To determine the extent to which recommended paracetamol loading doses are administered in an academic paediatric hospital and to determine whether paracetamol loading doses are necessary to achieve the therapeutic target concentration of 10 mg/L in (pre)term neonates and children.</p><p><strong>Methods: </strong>A retrospective study was performed including (pre)term neonates and children who were hospitalised between 1 January 2023 and 1 January 2024 and received at least one dose of intravenous or rectal paracetamol. The number of treatments with and without a paracetamol loading dose was evaluated. Pharmacokinetic simulations were performed to determine the effect of the loading dose on paracetamol steady-state concentrations (C<sub>ss</sub>).</p><p><strong>Results: </strong>We included 911 intravenous and 1402 rectal treatment periods, with loading doses administered in 21% and 1% of the cases, respectively. Pharmacokinetic simulations show that an intravenous or rectal loading dose reaches C<sub>ss</sub> concentrations within the first dose, while without a loading dose, C<sub>ss</sub> is only reached after 12 hours for intravenous and 18 hours for rectal administration.</p><p><strong>Conclusion: </strong>Our results indicate that in most cases, paracetamol loading doses are not administered in an academic paediatric hospital, which will strongly delay paracetamol C<sub>ss</sub>. We conclude that the treatment of (pre)term neonates and children with paracetamol can and should be improved.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Paracetamol loading dose administration in children: a retrospective study.\",\"authors\":\"Alise D E de Groot, Marijke A J van der Wagt, Nieko C Punt, Daan J Touw, Henkjan J Verkade, Paola Mian\",\"doi\":\"10.1136/ejhpharm-2025-004496\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To determine the extent to which recommended paracetamol loading doses are administered in an academic paediatric hospital and to determine whether paracetamol loading doses are necessary to achieve the therapeutic target concentration of 10 mg/L in (pre)term neonates and children.</p><p><strong>Methods: </strong>A retrospective study was performed including (pre)term neonates and children who were hospitalised between 1 January 2023 and 1 January 2024 and received at least one dose of intravenous or rectal paracetamol. The number of treatments with and without a paracetamol loading dose was evaluated. Pharmacokinetic simulations were performed to determine the effect of the loading dose on paracetamol steady-state concentrations (C<sub>ss</sub>).</p><p><strong>Results: </strong>We included 911 intravenous and 1402 rectal treatment periods, with loading doses administered in 21% and 1% of the cases, respectively. Pharmacokinetic simulations show that an intravenous or rectal loading dose reaches C<sub>ss</sub> concentrations within the first dose, while without a loading dose, C<sub>ss</sub> is only reached after 12 hours for intravenous and 18 hours for rectal administration.</p><p><strong>Conclusion: </strong>Our results indicate that in most cases, paracetamol loading doses are not administered in an academic paediatric hospital, which will strongly delay paracetamol C<sub>ss</sub>. We conclude that the treatment of (pre)term neonates and children with paracetamol can and should be improved.</p>\",\"PeriodicalId\":12050,\"journal\":{\"name\":\"European journal of hospital pharmacy : science and practice\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-05-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European journal of hospital pharmacy : science and practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/ejhpharm-2025-004496\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European journal of hospital pharmacy : science and practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/ejhpharm-2025-004496","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
Paracetamol loading dose administration in children: a retrospective study.
Objective: To determine the extent to which recommended paracetamol loading doses are administered in an academic paediatric hospital and to determine whether paracetamol loading doses are necessary to achieve the therapeutic target concentration of 10 mg/L in (pre)term neonates and children.
Methods: A retrospective study was performed including (pre)term neonates and children who were hospitalised between 1 January 2023 and 1 January 2024 and received at least one dose of intravenous or rectal paracetamol. The number of treatments with and without a paracetamol loading dose was evaluated. Pharmacokinetic simulations were performed to determine the effect of the loading dose on paracetamol steady-state concentrations (Css).
Results: We included 911 intravenous and 1402 rectal treatment periods, with loading doses administered in 21% and 1% of the cases, respectively. Pharmacokinetic simulations show that an intravenous or rectal loading dose reaches Css concentrations within the first dose, while without a loading dose, Css is only reached after 12 hours for intravenous and 18 hours for rectal administration.
Conclusion: Our results indicate that in most cases, paracetamol loading doses are not administered in an academic paediatric hospital, which will strongly delay paracetamol Css. We conclude that the treatment of (pre)term neonates and children with paracetamol can and should be improved.
期刊介绍：
European Journal of Hospital Pharmacy (EJHP) offers a high quality, peer-reviewed platform for the publication of practical and innovative research which aims to strengthen the profile and professional status of hospital pharmacists. EJHP is committed to being the leading journal on all aspects of hospital pharmacy, thereby advancing the science, practice and profession of hospital pharmacy. The journal aims to become a major source for education and inspiration to improve practice and the standard of patient care in hospitals and related institutions worldwide.
EJHP is the only official journal of the European Association of Hospital Pharmacists.
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