Global antibiotic dosing strategies in hospitalised children: Characterising variation and implications for harmonisation of international guidelines.

<h4>Background</h4>Paediatric global antibiotic guidelines are inconsistent, most likely due to the limited pharmacokinetic and efficacy data in this population. We investigated factors underlying variation in antibiotic dosing using data from five global point prevalence surveys.<h4&...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Michelle N Clements, Neal Russell, Julia A Bielicki, Sally Ellis, Silke Gastine, Yingfen Hsia, Joseph F Standing, A Sarah Walker, Mike Sharland
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4646d65cd5f64487805d814e462a3846
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:4646d65cd5f64487805d814e462a3846
record_format	dspace
spelling	oai:doaj.org-article:4646d65cd5f64487805d814e462a38462021-11-25T06:23:41ZGlobal antibiotic dosing strategies in hospitalised children: Characterising variation and implications for harmonisation of international guidelines.1932-620310.1371/journal.pone.0252223https://doaj.org/article/4646d65cd5f64487805d814e462a38462021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252223https://doaj.org/toc/1932-6203<h4>Background</h4>Paediatric global antibiotic guidelines are inconsistent, most likely due to the limited pharmacokinetic and efficacy data in this population. We investigated factors underlying variation in antibiotic dosing using data from five global point prevalence surveys.<h4>Methods & findings</h4>Data from 3,367 doses of the 16 most frequent intravenous antibiotics administered to children 1 month-12 years across 23 countries were analysed. For each antibiotic, we identified standard doses given as either weight-based doses (in mg/kg/day) or fixed daily doses (in mg/day), and investigated the pattern of dosing using each strategy. Factors underlying observed variation in weight-based doses were investigated using linear mixed effects models. Weight-based dosing (in mg/kg/day) clustered around a small number of peaks, and all antibiotics had 1-3 standard weight-based doses used in 5%-48% of doses. Dosing strategy was more often weight-based than fixed daily dosing for all antibiotics apart from teicoplanin, which had approximately equal proportions of dosing attributable to each strategy. No strong consistent patterns emerged to explain the historical variation in actual weight-based doses used apart from higher dosing seen in central nervous system infections, and lower in skin and soft tissue infections compared to lower respiratory tract infections. Higher dosing was noted in the Americas compared to the European region.<h4>Conclusions</h4>Antibiotic dosing in children clusters around a small number of doses, although variation remains. There is a clear opportunity for the clinical, scientific and public health communities to consolidate behind a consistent set of global antibiotic dosing guidelines to harmonise current practice and prioritise future research.Michelle N ClementsNeal RussellJulia A BielickiSally EllisSilke GastineYingfen HsiaJoseph F StandingA Sarah WalkerMike SharlandPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0252223 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Michelle N Clements Neal Russell Julia A Bielicki Sally Ellis Silke Gastine Yingfen Hsia Joseph F Standing A Sarah Walker Mike Sharland Global antibiotic dosing strategies in hospitalised children: Characterising variation and implications for harmonisation of international guidelines.
description	<h4>Background</h4>Paediatric global antibiotic guidelines are inconsistent, most likely due to the limited pharmacokinetic and efficacy data in this population. We investigated factors underlying variation in antibiotic dosing using data from five global point prevalence surveys.<h4>Methods & findings</h4>Data from 3,367 doses of the 16 most frequent intravenous antibiotics administered to children 1 month-12 years across 23 countries were analysed. For each antibiotic, we identified standard doses given as either weight-based doses (in mg/kg/day) or fixed daily doses (in mg/day), and investigated the pattern of dosing using each strategy. Factors underlying observed variation in weight-based doses were investigated using linear mixed effects models. Weight-based dosing (in mg/kg/day) clustered around a small number of peaks, and all antibiotics had 1-3 standard weight-based doses used in 5%-48% of doses. Dosing strategy was more often weight-based than fixed daily dosing for all antibiotics apart from teicoplanin, which had approximately equal proportions of dosing attributable to each strategy. No strong consistent patterns emerged to explain the historical variation in actual weight-based doses used apart from higher dosing seen in central nervous system infections, and lower in skin and soft tissue infections compared to lower respiratory tract infections. Higher dosing was noted in the Americas compared to the European region.<h4>Conclusions</h4>Antibiotic dosing in children clusters around a small number of doses, although variation remains. There is a clear opportunity for the clinical, scientific and public health communities to consolidate behind a consistent set of global antibiotic dosing guidelines to harmonise current practice and prioritise future research.
format	article
author	Michelle N Clements Neal Russell Julia A Bielicki Sally Ellis Silke Gastine Yingfen Hsia Joseph F Standing A Sarah Walker Mike Sharland
author_facet	Michelle N Clements Neal Russell Julia A Bielicki Sally Ellis Silke Gastine Yingfen Hsia Joseph F Standing A Sarah Walker Mike Sharland
author_sort	Michelle N Clements
title	Global antibiotic dosing strategies in hospitalised children: Characterising variation and implications for harmonisation of international guidelines.
title_short	Global antibiotic dosing strategies in hospitalised children: Characterising variation and implications for harmonisation of international guidelines.
title_full	Global antibiotic dosing strategies in hospitalised children: Characterising variation and implications for harmonisation of international guidelines.
title_fullStr	Global antibiotic dosing strategies in hospitalised children: Characterising variation and implications for harmonisation of international guidelines.
title_full_unstemmed	Global antibiotic dosing strategies in hospitalised children: Characterising variation and implications for harmonisation of international guidelines.
title_sort	global antibiotic dosing strategies in hospitalised children: characterising variation and implications for harmonisation of international guidelines.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/4646d65cd5f64487805d814e462a3846
work_keys_str_mv	AT michellenclements globalantibioticdosingstrategiesinhospitalisedchildrencharacterisingvariationandimplicationsforharmonisationofinternationalguidelines AT nealrussell globalantibioticdosingstrategiesinhospitalisedchildrencharacterisingvariationandimplicationsforharmonisationofinternationalguidelines AT juliaabielicki globalantibioticdosingstrategiesinhospitalisedchildrencharacterisingvariationandimplicationsforharmonisationofinternationalguidelines AT sallyellis globalantibioticdosingstrategiesinhospitalisedchildrencharacterisingvariationandimplicationsforharmonisationofinternationalguidelines AT silkegastine globalantibioticdosingstrategiesinhospitalisedchildrencharacterisingvariationandimplicationsforharmonisationofinternationalguidelines AT yingfenhsia globalantibioticdosingstrategiesinhospitalisedchildrencharacterisingvariationandimplicationsforharmonisationofinternationalguidelines AT josephfstanding globalantibioticdosingstrategiesinhospitalisedchildrencharacterisingvariationandimplicationsforharmonisationofinternationalguidelines AT asarahwalker globalantibioticdosingstrategiesinhospitalisedchildrencharacterisingvariationandimplicationsforharmonisationofinternationalguidelines AT mikesharland globalantibioticdosingstrategiesinhospitalisedchildrencharacterisingvariationandimplicationsforharmonisationofinternationalguidelines
_version_	1718413739917574144

Global antibiotic dosing strategies in hospitalised children: Characterising variation and implications for harmonisation of international guidelines.

Ejemplares similares