Prescription du paracétamol dans cinq centres hospitaliers français : quelles sont les pratiques ?

Hepatotoxicity risk factors and acetaminophen dose adjustment, do prescribers give this issue adequate consideration? A French university hospital study

“…The lower non-compliant prescriptions could be related to the fact that age > 75 years is not considered as a HRF in SmPC and no dose adjustment is recommended. As mentioned by Pacé et al, medicine and geriatric units seem to be more aware of the HRFs of acetaminophen [31]: in our study the number of prescriptions for < 4 g/day in these units amounted to around 85 % of the prescriptions.…”

“…In our seven-day study focusing on acetaminophen prescriptions in Rennes University Hospital, around three quarters of prescriptions were full-dose (4 g/day); in this group, 47 % of prescriptions were for patients with at least one HRF: these can be considered as non-compliant prescriptions, and the proportion is greater than in previous studies showing up to 21 % of non-compliant acetaminophen prescriptions in hospital [27][28][29][30][31]. The lower non-compliant prescriptions could be related to the fact that age > 75 years is not considered as a HRF in SmPC and no dose adjustment is recommended.…”

“…Few studies have described acetaminophen prescription patterns in hospitals or assessed compliance with recommendations relating to HRFs: in French and American cohorts, failure to adjust doses in view of the presence of HRFs was observed in 1 % to 21 % of prescriptions [27][28][29][30][31]. It can be noted that neither the type of hospital units (surgery, geriatrics...) nor pharmaceutical validation studies have an influence on dose adjustment [27,30].…”

Insuficiencia hepática aguda por sobredosis accidental de paracetamol. Causas

“…La labor de los farmacéuticos de varios hospitales franceses (13)(14)(15) , en la supervisión del tratamiento prescrito con paracetamol, permitió detectar errores de prescripción y su posterior corrección a la dosis adecuada al paciente. En 1256 prescripciones, el 21% de ellas, no estaban adaptadas:…”

“…al peso, al consumo crónico de alcohol, o bien, por la alteración previa renal o hepática (13) . En otro hospital, analizadas 343 prescripciones: el 14% no se adaptaron al peso en menores de 50 Kg., o bien no se tuvo en cuenta la edad superior de 65 años; y el 17% no tuvieron en cuenta la psicopatología (14) .…”