Ensuring safe drug administration to pediatric patients with renal dysfunction: a multicenter study

Area of Science:

• Pediatric Nephrology
• Clinical Pharmacy
• Pharmacology

Background:

• Pediatric renal dysfunction often goes undetected due to variable serum creatinine (Cr) reference values.
• This can lead to inappropriate administration of renally excreted or nephrotoxic drugs in children.
• Physicians may lack awareness of these critical drug safety considerations.

Purpose of the Study:

• To assess the awareness of physicians and pharmacists regarding pediatric renal function and drug safety.
• To identify knowledge gaps in managing medications for pediatric patients with impaired renal function.

Main Methods:

• A questionnaire was administered to pediatric physicians and pharmacists at six Tokyo hospitals.
• Participants were queried on serum Cr reference ranges and knowledge of drug excretion and nephrotoxicity.

Main Results:

• Physicians demonstrated higher accuracy in stating pediatric serum Cr ranges than pharmacists.
• Awareness of renally excreted drugs (e.g., histamine H2-receptor antagonists, oseltamivir) and nephrotoxic drugs (e.g., acyclovir) was limited among physicians.
• Pharmacists showed better recognition of renally excreted drugs but overall awareness regarding dosage adjustments for renal dysfunction was insufficient.

Conclusions:

• There is a significant gap in awareness concerning drug dosage adjustments for pediatric renal dysfunction.
• Enhanced communication between physicians and pharmacists is essential for safe drug administration.
• Developing a dedicated protocol for safe medication management in pediatric patients with renal impairment is urgently needed.