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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Optimized antimicrobial dosing strategies: a survey of pediatric hospitals

Chad A Knoderer1, Kristen R Nichols, Elaine G Cox

  • 1Department of Pharmacy Practice, College of Pharmacy and Health Sciences, Butler University, 4600 Sunset Ave., Indianapolis, IN, 46208, USA, cknodere@butler.edu.

Paediatric Drugs
|October 16, 2014
PubMed

Insights

Extended-interval aminoglycoside (EIAG) dosing is common in pediatric hospitals, but extended- and continuous-infusion beta-lactam (EIBL and CIBL) strategies are less utilized due to efficacy and logistical concerns.

Area of Science:

  • Pediatric pharmacology
  • Antimicrobial stewardship
  • Clinical pharmacy practice

Background:

  • Extended-interval aminoglycoside (EIAG) and extended- and continuous-infusion beta-lactam (EIBL and CIBL) dosing strategies are increasingly used in adults.
  • Pediatric literature on these dosing strategies is limited.

Purpose of the Study:

  • To describe the current use of EIAG, EIBL, and CIBL dosing strategies in pediatric hospitals across the USA.
  • To identify barriers to the adoption of these advanced antimicrobial dosing regimens in pediatric care.

Main Methods:

  • A national survey was conducted among children's hospitals in the USA.
  • Practitioners were identified through the Children's Hospital Association to complete practice-based survey questions.
  • The survey assessed the utilization of EIAG, EIBL, and CIBL dosing and reasons for non-use.

Main Results:

  • Extended-interval aminoglycoside (EIAG) dosing is utilized in 63% of responding hospitals.
  • Extended- and continuous-infusion beta-lactam (EIBL and CIBL) dosing are used in 24% and 13% of hospitals, respectively.
  • Primary reasons for not using EIAG include concerns about efficacy data and drug-free periods; for EIBL, concerns include lack of pediatric efficacy data, IV access needs, and compatibility issues.

Conclusions:

  • EIAG dosing is widely adopted in over half of surveyed pediatric hospitals.
  • EIBL and CIBL dosing strategies show lower adoption rates, with less than 25% utilization.
  • Further research and evidence generation are needed to support increased utilization of EIBL and CIBL dosing in pediatric settings.
Abstract

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