A cross-sectional survey on knowledge, attitude, and practices among medical and dental practitioners regarding intravenous paracetamol

Intravenous paracetamol (IV PCM) is a commonly used analgesic and antipyretic with a rapid onset of action. However, concerns regarding hepatotoxicity, cost, and dosing errors continues.

To assess the knowledge, attitude, and practices related to IV PCM use among allopathic medical and dental practitioners.

A cross-sectional survey was conducted across five Indian cities over five months. A structured questionnaire was distributed electronically via Google Forms. Data were analysed using descriptive statistics and the Chi-square test, with p < 0.05 set as a significance level.

Among 212 participants (response rate: 46.39%), 160 (75.47%) selected IV PCM to be more effective than oral or rectal routes, many preferred nonsteroidal anti-inflammatory drugs (94, 44.34%) or oral PCM (90, 42.45%) as first-line therapy. Around 139 (65.57%) practitioners reported the absence of institutional guidelines, however no significant association was observed between the presence of guidelines and knowledge level (p = 0.217). Furthermore, inconsistent practices were observed including prescribing IV PCM (i) more than the recommended dose based on weight , (ii) for neonates (69, 32.55%) and infants (117, 55.19%), (iii) for > 3 days (> 10%), and (iv) vial beyond 30 min (100, 47.17%). Attitudes varied regarding the need for region-specific guidelines and safety monitoring practices.

A varying knowledge and inconsistent prescribing practices were observed among practitioners. Many were unaware of standard dosing recommendations and reported the absence of institutional guidelines. Thus, institutional guidelines with strict adherence to them and continued professional education may promote the safe and rational use of IV PCM.