Children should not be considered 'small adults' when it comes to prescribing medications, but it can be difficult to determine the right dosage of a particular drug for young patients.
A new British Journal of Clinical Pharmacology article analysed drug dosage guidelines and found that guidelines given for paediatric doses are usually based on simple formulas (such as mg/kg), available dosing formulations, and prior patterns of use. The analysis also found that it is common to find two or more-fold variation in the doses suggested in the guidelines from doses predicted by allometric scaling—which considers a dose for children to be a partial adult dose, dependent on variable factors of age, height and weight. Arbitrary large shifts in recommended doses at certain age limits were also common within the guidelines.
"The increasing focus on paediatric dosing is a positive development, especially with the development of paediatric focused formularies in the last decade. However, there is still a lot of room for improvement," said lead author Dr. Kate Chitty, of The University of Sydney, in Australia.
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Kate M. Chitty et al, Discontinuities and disruptions in drug dosage guidelines for the paediatric population, British Journal of Clinical Pharmacology (2018). DOI: 10.1111/bcp.13511