Characteristics of medication errors in pediatrics.

A six-month prospective study was carried out by 16 poison control centers in France to assess the epidemiology of medication errors in pediatrics. In this study, 1108 medication errors were analyzed. Mean population age was 3.2 years (median 2 years, range 3 days-15 years), and 30 percent of the children were under 1 year of age. The most frequent error characteristics were family responsibility, 87 percent (a member of the patient's family most often committed the error in medication use); parental prescribing decision, 31.5 percent (medication administered to the child by the parents without medical consultation or the advice of a pharmacist); incorrect execution of the prescription by the parents, 30 percent (error in dispensing, route of administration, etc.); oral forms, 52 percent (errors occurred most frequently with oral as opposed to other forms); incorrect dosage, 31.5 percent; and drug error, 30 percent (the drug dispensed was not the one prescribed). Iatrogenic injury occurred in 186 patients (17 percent) and 161 were hospitalized (15 percent). The majority of these were for surveillance only. The clinical outcome caused by medication error was unfavorable in two cases. The types of drugs most frequently misused included morphinic cough suppressants (9.5 percent), salicylates (9.1 percent), and ear, nose, and throat drops (9 percent); 459 proprietary medicines were specified. Prevention of medication errors should involve certain main requirements: formulations and package instructions specific to pediatric patients to ensure appropriateness and accuracy, detailed information given to patients by physicians and pharmacists about their prescriptions, and more public information concerning the risks of remedies or medication administered to children by parents who do not seek medical advice.