Underdosing of acetaminophen by parents and emergency department utilization

Pediatr Emerg Care. 2004 Feb;20(2):89-93. doi: 10.1097/01.pec.0000113877.10140.d2.


Objectives: Fever is a common reason for parents to seek medical attention for their children. We conducted this study to document accuracy of parental administration of acetaminophen and to identify if parents who did not give an optimal dose would have decided not to come to the emergency department (ED) if the fever had diminished at home.

Methods: A cross-sectional study including 248 caregivers of children who had a chief complaint of fever and had been given acetaminophen in the preceding 24 hours were interviewed.

Results: Enrollment was 86%. One hundred parents (47%) gave acetaminophen in the recommended dose, 26 parents (12%) gave an overdose, and 87 (41%) gave an underdose of acetaminophen. Half of the parents (54%) would not have come to the ED if the fever had subsided after using the antipyretic treatment at home. Children with significantly higher maximal temperature at home would not have been taken to the ED if fever had subsided. Parents who speak English as the primary language at home gave the recommended dose of acetaminophen more frequently than non-English-speaking parents.

Conclusion: A significant portion of our population gives an underdose of acetaminophen, reflecting lack of knowledge or misuse. Based on parental reports, the majority of visits for fever might have been prevented, if parents had been successful in their effort to reduce temperature to below of what they considered as fever, but factors other than underdosing of acetaminophen probably encourage parents of febrile children to visit the ED.

Publication types

  • Comparative Study

MeSH terms

  • Acetaminophen / administration & dosage*
  • Adolescent
  • Analgesics, Non-Narcotic / administration & dosage*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Fever / drug therapy*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Parents


  • Analgesics, Non-Narcotic
  • Acetaminophen