A comparison of five paediatric dosing guidelines for antibiotics
- 1 June 2020
- journal article
- research article
- Published by WHO Press in Bulletin of the World Health Organization
- Vol. 98 (6), 406-+
- https://doi.org/10.2471/BLT.19.234310
Abstract
Objective To compare dosing guidance in the paediatric formularies of high-and middle-income countries for 32 commonly prescribed antibiotics on the World Health Organization's (WHO's) 2017 Model list of essential medicines for children. Methods We identified paediatric antibiotic guidelines that were either widely used internationally or originated from countries in which antibiotic use has increased markedly in recent years (i.e. Brazil, China, India, the Russian Federation and South Africa). Findings The study analysis considered five leading antibiotic guidelines: (i) the Manual of childhood infections: the blue book; (ii) the BNF (British national formulary) for children; (iii) the Red boor: 2018-2021 report of the committee on infectious diseases; (iv) WHO's Pocket book of hospital care forchildren; and (v) Indian National treatment guidelines for antimicrobial use in infectious diseases.There was marked heterogeneity in the recommended dosing (i.e. daily dose, age dosing bands and dose frequency) for most commonly used antibiotics.The rationale for dosing recommendations was generally unclear. Conclusion The pharmacokinetic, pharmacodynamic and clinical evidence supporting paediatric antibiotic dosing, particularly on total doses and on age or weight dosing bands, needs to be improved. Future research should consider whether the variations in guidance identified stem from different clinical disease patterns, varying levels of antibiotic resistance or drug availability rather than historical preferences. Interested global parties could collaborate with WHO's Model list of essential medicines antibiotic working group to develop an evidence-based consensus and identify research priorities.This publication has 23 references indexed in Scilit:
- Consumption of oral antibiotic formulations for young children according to the WHO Access, Watch, Reserve (AWaRe) antibiotic groups: an analysis of sales data from 70 middle-income and high-income countriesThe Lancet Infectious Diseases, 2018
- Global shortage of neonatal and paediatric antibiotic trials: rapid reviewBMJ Open, 2017
- Variation in paediatric hospital antibiotic guidelines in EuropeArchives of Disease in Childhood, 2015
- Reported Rates of Diarrhea Following Oral Penicillin Therapy in Pediatric Clinical TrialsThe Journal of Pediatric Pharmacology and Therapeutics, 2015
- Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV‐1 infection 2015: optimizing health in preparation for adult lifeHIV Medicine, 2015
- European survey on principles of prudent antibiotic prescribing teaching in undergraduate studentsClinical Microbiology & Infection, 2014
- Global antibiotic consumption 2000 to 2010: an analysis of Cross Mark 742 national pharmaceutical sales dataThe Lancet Infectious Diseases, 2014
- Getting the dose of vancomycin right in the neonate.International journal of clinical pharmacology and therapeutics, 2011
- Junior doctors' knowledge and perceptions of antibiotic resistance and prescribing: a survey in France and ScotlandClinical Microbiology & Infection, 2011
- Survey of unlicensed and off label drug use in paediatric wards in European countriesBMJ, 2000