Introduction Paediatric polypharmacy is defined as two or more medicines, which is lower than the definition in adults (>5 medicines). A recent scoping review of paediatric polypharmacy found a mean prevalence of 39.7% with a large range from 0.9% to 98.4%.

Methods Prescribing data from 85 active practices across Liverpool Clinical Commissioning Group (CCG), was extracted on the 6th January 2021 to include all patients below 18 years of age. Prescribing data was also obtained for Alder Hey Children’s Hospital from the electronic prescribing system, Meditech on the 12th January 2021. Descriptive analysis was performed.

Results Of the 110,097 CYP registered in primary care, 17,271 (16%) were prescribed >2 medications, 3,507 (3·2%) >5, 715 (0·7%) ≥10, and 202 (0·2%) ≥15. The median number of CYP prescribed ≥10 and ≥15 medications per primary care practice was 7 (range 0–34) and 2 (range 0–11), respectively.

Within Alder Hey Children’s Hospital, 139 inpatients were identified, with 126 patients (91%) prescribed two or more medicines. The most frequently prescribed medicine was paracetamol. When ‘as required’ and ‘one off’ medicines were removed, omeprazole was the most frequently prescribed medicine.

Conclusions Many children within Liverpool CCG meet the definition for paediatric polypharmacy. Further research is required to assess the consequences of paediatric polypharmacy and address its management which is under recognised and underrepresented in the literature to date.