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  • Clinical Research Article
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Ibuprofen dosing measurement accuracy using infants’ versus children’s ibuprofen: a randomized crossover comparison

Pediatric Research volume 94, pages 1145–1150 (2023)Cite this article

Abstract

Background

Ibuprofen liquid comes in two pediatric concentrations: 200 mg/5 mL for infants and 100 mg/5 mL for children. This study aimed to investigate the misdosing of ibuprofen liquid products by comparing administration accuracy with differing pediatric concentrations and dosages.

Methods

Subject selection included 116 volunteers. Participants were provided with the children’s ibuprofen package including the dosing cup, the infants’ ibuprofen package including the infant dosing dropper, and a 5 mL syringe. Each subject drew up a specified dose of infants’ ibuprofen and children’s ibuprofen and deposited each sample into a graduated cylinder. The dose (70 or 100 mg) and order of concentration usage (infants’ first or children’s first) were randomized.

Results

A total of 116 subjects, with a mean age of 32 ± 14 years, participated in the study. Mean absolute dosing errors for all trials, including those who made no errors, were significantly higher for infants’ ibuprofen compared to children’s ibuprofen: 39 vs. 27 mg (p = 0.036). A total of 31% of all ibuprofen dosage experiments (71 of 232 trials) had greater than 50% error of the assigned dose.

Conclusion

Dosage errors using infants’ ibuprofen were significantly higher than the children’s ibuprofen. This suggests that removing the infant form from consumer availability may help reduce dosing errors when administering ibuprofen to pediatric patients.

Impact

  • Pediatric misdosing is a significant problem with over-the-counter medications, such as ibuprofen. A previous study found that 51% of patients under the age of 10 were inaccurately dosed with antipyretic medication, including ibuprofen, with an increased incidence in infants.

  • We found significantly more dosing errors with the infant concentration (200 mg/5 mL) as opposed to the children’s concentration (100 mg/5 mL), 39 vs. 27 mg, respectively (p = 0.036).

  • We believe that this research is beneficial to pediatric patient caregivers, clinicians, and policymakers to identify the problem of inaccurate ibuprofen dosing and to propose a way to mitigate this by having one concentration easily accessible.

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Fig. 1: Study flow diagram.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank all participants from the study.

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Authors and Affiliations

  1. Department of Pediatrics, University of Hawai’i John A. Burns School of Medicine, Honolulu, HI, USA

    Emily R. Leibovitch, Alyssa S. Fujiwara, Ian K. H. Chun, Nathaniel C. Villanueva & Loren G. Yamamoto

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  1. Emily R. Leibovitch
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  2. Alyssa S. Fujiwara
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  3. Ian K. H. Chun
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  4. Nathaniel C. Villanueva
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  5. Loren G. Yamamoto
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Contributions

All the authors contributed to each of the following points: substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; and final approval of the version to be published.

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Correspondence to Emily R. Leibovitch.

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Leibovitch, E.R., Fujiwara, A.S., Chun, I.K.H. et al. Ibuprofen dosing measurement accuracy using infants’ versus children’s ibuprofen: a randomized crossover comparison. Pediatr Res 94, 1145–1150 (2023). https://doi.org/10.1038/s41390-023-02573-7

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