Assessment of Parental Knowledge and Awareness Regarding Paracetamol Usage and Toxicity at Lady Ridgeway Hospital for Children, Sri Lanka

Introduction: Paracetamol is widely used in paediatric care as an antipyretic and analgesic, yet misuse and incorrect dosing can lead to toxicity. This study assessed parental knowledge and awareness of paracetamol use and toxicity at Lady Ridgeway Hospital for Children, Sri Lanka. 
Methods: A descriptive cross-sectional study among 402 parents utilised a structured questionnaire to evaluate demographics, paracetamol dosing knowledge, indications, toxicity, and sources of information. Statistical analysis examined associations between knowledge levels and demographic factors. 
Results: Most participants (75.9%) were female, with a mean age of 34.01 ± 7.54 years. A majority (75.9%) had an education level between O/L and A/L, while 12.2% had higher education. Employment status varied, with 54.7% unemployed and 45.3% employed. Nearly all (98.5%) administered paracetamol without prior medical consultation, mostly for fever (98.0%). Only 42.8% correctly identified 100.4°F (38°C) as the threshold for antipyretic use, and 43.3% were unaware of the shelf life of opened syrup. While 90.3% recognised overdose risks, awareness of specific toxicity effects was limited. Gender (p=0.005), education (p=0.030), and income (p=0.003) were significantly associated with knowledge levels. 
Conclusions: The study highlights significant gaps in parental knowledge regarding the proper use and potential toxicity of paracetamol, particularly among male participants and those with lower educational levels and incomes. Despite an awareness of overdose risks, misconceptions persist, especially concerning fever thresholds and appropriate dosing frequency. To promote safer paediatric paracetamol use, targeted educational initiatives and enhanced guidance from healthcare professionals are essential.