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A comparison of five paediatric dosing guidelines for antibiotics

Mathur, S; Jackson, C; Urus, H; Ziarko, I; Goodbun, M; Hsia, Y; Ellis, S; Sharland, M (2020) A comparison of five paediatric dosing guidelines for antibiotics. BULLETIN OF THE WORLD HEALTH ORGANIZATION. ISSN 0042-9686
SGUL Authors: Hsia, Yingfen Sharland, Michael Roy

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Objective To compare dosing guidance in the paediatric formularies of high-income countries and emerging economies 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 in 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 book®: 2018–2021 report of the committee on infectious diseases; (iv) WHO’s Pocket book of hospital care for children; 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.

Item Type: Article
Additional Information: All articles are available under the Creative Commons Attribution 3.0 IGO licence (CC BY 3.0 IG0) and are freely available online:
Keywords: Tropical Medicine, 11 Medical and Health Sciences
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
ISSN: 0042-9686
Related URLs:
28 April 2020Published Online
17 March 2020Accepted
Publisher License: Creative Commons: Attribution 3.0 IGO

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