In:
PLOS ONE, Public Library of Science (PLoS), Vol. 16, No. 5 ( 2021-5-27), p. e0252223-
Abstract:
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. Methods & findings 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. Conclusions 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.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0252223
DOI:
10.1371/journal.pone.0252223.g001
DOI:
10.1371/journal.pone.0252223.g002
DOI:
10.1371/journal.pone.0252223.g003
DOI:
10.1371/journal.pone.0252223.g004
DOI:
10.1371/journal.pone.0252223.t001
DOI:
10.1371/journal.pone.0252223.s001
DOI:
10.1371/journal.pone.0252223.s002
DOI:
10.1371/journal.pone.0252223.s003
DOI:
10.1371/journal.pone.0252223.s004
DOI:
10.1371/journal.pone.0252223.s005
DOI:
10.1371/journal.pone.0252223.s006
DOI:
10.1371/journal.pone.0252223.s007
DOI:
10.1371/journal.pone.0252223.s008
DOI:
10.1371/journal.pone.0252223.s009
DOI:
10.1371/journal.pone.0252223.s010
DOI:
10.1371/journal.pone.0252223.s011
DOI:
10.1371/journal.pone.0252223.s012
DOI:
10.1371/journal.pone.0252223.s013
DOI:
10.1371/journal.pone.0252223.s014
DOI:
10.1371/journal.pone.0252223.s015
DOI:
10.1371/journal.pone.0252223.s016
DOI:
10.1371/journal.pone.0252223.r001
DOI:
10.1371/journal.pone.0252223.r002
DOI:
10.1371/journal.pone.0252223.r003
DOI:
10.1371/journal.pone.0252223.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2021
detail.hit.zdb_id:
2267670-3
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