Doctors and pharmacies might be giving babies and toddlers overdoses of prescription painkillers, researchers from the Medical University of South Carolina found.

The researchers, led by Dr. William Basco, director of MUSC's Division of General Pediatrics, hope the study will lead to more cautious and possibly automatic drug dispensing. They now will study whether the overdoses led to patient harm.

The research, presented at the annual meeting of the Pediatric Academic Societies in Denver last month, studied South Carolina Medicaid records of the top 19 narcotic-containing drugs prescribed to newborns through age 3 from 2000 to 2006.

Basco's team compared more than 50,000 actual narcotics prescriptions to the expected daily dose of the drugs based on the child's age, gender and a conservative estimate of his or her weight. They found that:

--4.1 percent of actual prescriptions were overdoses

--Most overdose prescriptions, about 40 percent, were dispensed to babies 2 months old and younger. That compares with 3 percent of prescriptions for children more than one year old.

--Among the overdose prescriptions, the amount of narcotic drug dispensed was an average of 42 percent more than expected.

Narcotics such as codeine and hydrocodone, which are prescribed for babies as cough suppressants and painkillers, can be particularly dangerous for infants and children because of their sedative effects, Basco said. Sedation raises the risk of dehydration because infants and toddlers do not wake up enough to eat or drink; severe cases could lead to breathing problems and even death, he said.

For the research, Basco's team assumed each child's weight was in the 97th percentile for his or her age.

Basco said he did not know how many children were involved in the study.

The narcotics in question all were administered in liquid form, Basco said. Earlier research has showed wide errors in administering liquid medicine, even when the proper amount is prescribed, he said.

"We need to focus on how to deliver these drugs safely to young children," he said.

Possible solutions include automating the prescription process, so that doses would be calculated based on a child's precise weight, he said.

Basco's team conducted the research using a four-year, $508,000 federal grant from the Agency for Healthcare Research and Quality, he said.

Reach Renee Dudley at 937-5550.