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Pediatric dosing--the pharmacist's dilemma
Contemporary Pharmacy Practice
|December 7, 1980
Summary
Pediatric dosing rules like Clark's are unreliable for determining actual patient doses. Shirkey's recommendations offered the most reasonable approach, though careful pharmacist monitoring is essential for safe pediatric medication.
Area of Science:
- Pediatric Pharmacology
- Drug Dosing
- Clinical Pharmacy
Background:
- Commonly published pediatric dosing rules are often considered unreliable by medical authorities.
- Existing rules include Clark's weight rule, Clark's surface area rule, and Young's age rule.
Purpose of the Study:
- To compare actual pediatric doses administered with doses calculated using various published pediatric dosing rules.
- To evaluate the reliability and appropriateness of different pediatric dosing calculation methods.
Main Methods:
- A comparative study was conducted in a pediatric hospital.
- Actual patient doses were compared to calculated doses using Clark's weight rule, Clark's surface area rule, Young's age rule, and Shirkey's recommendations.
- Statistical analysis using a t test for paired comparisons was performed.
Main Results:
- Actual administered doses significantly differed from calculated doses for most rules.
- Clark's surface area rule showed the greatest dosage deviation range, indicating unreliability.
- Doses calculated using Clark's surface area rule did not differ significantly from actual doses administered.
Conclusions:
- Published pediatric dosing rules, including Clark's weight and surface area rules, are not consistently reliable for determining appropriate pediatric medication doses.
- Shirkey's dosing recommendations presented the most reasonable method among those evaluated.
- Close monitoring by pharmacists and potential dosage adjustments are crucial for ensuring safe and effective pediatric dosing.