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Medicine measured by the spoonful can lead to dosage errors

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Reaching for a teaspoon or a tablespoon to administer liquid medicines can lead to potentially dangerous dosing errors, according to a study published in the July 14 online Pediatrics. Study findings showed that spoon-measured doses doubled the risk of incorrectly measuring the prescribed dosage.

Led by Shonna Yin, MD, an assistant professor of pediatrics at the New York University (NYU) School of Medicine in New York City, investigators analyzed data from a larger study involving 287 parents whose children were prescribed liquid medications while in the emergency room. The children were all younger than 9 years of age and most were prescribed antibiotics.

Yin and her colleagues contacted the parents in the study group after they returned home to determine how they had measured the prescribed doses. Parents also brought their measuring devices to the researchers’ offices to demonstrate how they gave their children the prescribed medicines.

Parents who used spoonfuls “were 50 percent more likely to give their children incorrect doses than those who measured in more precise milliliter units,” co-author Alan Mendelsohn, MD, an associate professor of pediatrics at the NYU School of Medicine, told ABC News.

Researchers found that parents using teaspoon or tablespoon measurements were 2.3 times more likely to incorrectly measure the doses they intended. In addition, 41.1 percent made an error in measuring what their doctor had prescribed.

The problem is that teaspoons and tablespoons are inaccurate measuring tools. “When you look at a kitchen spoon, the amount that will actually sit in the spoon is less likely to be exactly what it is meant to be,” co-author Ian Paul, MD, associate vice chair for research, department of pediatrics, at Penn State College of Medicine in Hershey, Penn., explained in HealthDay.

“You are less likely to get the right amount onto that spoon and then deliver it to the child,” added Paul.

And not delivering the right dose is potentially dangerous. Giving too little can mean that your child is not getting enough medicine to treat the illness and can lead to drug-resistant infections. Administering too much of the medicine can lead to side-effects that could be life-threatening.

Paul also noted that some parents had trouble distinguishing a teaspoon from a tablespoon as well as the abbreviation tsp. from tbsp. This was especially true, he said, for parents with low health literacy or those who had limited English-speaking skills.

Given the concerns about the potential dangers of overdosing and under dosing children, the authors recommend the use of the milliliter as the single standard unit of measurement for pediatric liquid medications. Organizations such as the American Academy of Pediatrics (AAP), Centers for Disease Control and Prevention (CDC), and the Institute for Safe Medication Practices support this recommendation.

Yin advises parents to ask their doctor or pharmacist to make their child’s prescription easier to administer.

“Parents should ask their doctor or pharmacist to tell them the dose in milliliters instead of teaspoons and tablespoons,” Yin told HealthDay. “Parents should also make sure to use a dosing device like an oral syringe, dropper or dosing spoon, to measure the dose. If the pharmacist does not provide it, I encourage parents to ask your pharmacist for one of their disposable syringes,” added Yin.



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