“More than 200,000 out-of-hospital medication errors are reported to U.S. poison control centers annually, and approximately 30% of these cases involve children under 6 years of age,” the American Academy of Pediatrics (AAP) said.

These mistakes occur outside of the hospital, doctor’s office or clinic and typically involve liquid medications (81.9%). The most common error was incorrect dosing: giving the wrong dose (17.8%); giving the correct dose, but inadvertently giving it twice (27%); or confusing the units of measure (8.2%), according to the study. Giving or taking the wrong medication was seen in 7.8% of cases.

Researchers from Nationwide Children’s Hospital, Central Ohio Poison Center and The Ohio State University College of Medicine, all in Columbus, reviewed data from the National Poison Database System and looked at medication errors that occurred in the community from 2002 through 2012 among children younger than age 6 years.

Younger children were more likely than their older peers to experience a medication error; children younger than 12 months accounted for more than 25% of medication errors, whereas children 5 years old accounted for less than 10%. Although it was unclear why more errors occurred in younger children, the researchers said there were probably multiple reasons, including the fact that older children can communicate with their parents. An older child can indicate that he or she has already taken the medication and avoid taking it twice. Additionally, very young children are more likely to be given a liquid formulation, and previous studies have shown that parents have trouble measuring liquid medications correctly (Arch Dis Child 2012;97:838-841). Medication errors involving tablets/capsules/caplets are only 14.9% of reports.

More errors occur in the winter than in the summer, according to the study results, probably due to the fact that more children are sick with respiratory infections in the winter. Although still high, medication errors involving asthma and cough and cold medications declined. This could be attributed to an advisory by the FDA and the AAP recommending that very young children, those younger than 2, not be given these medications. The researchers found that medication errors involving analgesics occurred in 25.2%, cough and cold preparations in 24.6%, antihistamines 15% and antimicrobial agents 11.8%.

“During the 11-year study period, cough and cold errors decreased significantly, whereas the rate of non-cough and cold medication errors increased for all ages,” the AAP said.

Medication errors involving cough and cold preparations decreased by almost 60% and asthma therapies decreased by 32.3%. In contrast, the frequency of errors with dietary supplements/herbal and homeopathic medications increased 765.3%, cardiovascular drugs by 87.5%, analgesics by 69.6%, anticonvulsants by 63.6%, antihistamines by 61.8% and muscle relaxants by 55.6%.

Although 25 children died as a result of a medication error, most were not life threatening, they said, and 94.1% did not require medical treatment. “Although medication errors involving young children occur frequently, serious medical outcomes are rare,” the researchers said.

The number of errors, even if they were not serious, warrants increased public health efforts to prevent them.

“Medications are confusing, and I think we need to make it less confusing,” Dr. Vaida said. Some actions he thought would help prevent medication errors are better labeling, clearer instructions and metric dosing.

The researchers also recommended that packaging be redesigned to provide accurate dosing devices and instructions, as well as better labeling to increase visibility to parents.