Optimized Antimicrobial Dosing Strategies

A Survey of Pediatric Hospitals

Chad A. Knoderer, Kristen R. Nichols, Elaine Cox

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Extended-interval aminoglycoside (EIAG) and extended- and continuous-infusion β-lactam (EIBL and CIBL) dosing strategies are increasingly used in adults, but pediatric literature is limited.

Objective: The objective of this study was to describe the use of EIAG, EIBL, and CIBL dosing in pediatric hospitals in the USA.

Study Design, Setting, and Participants: A national survey of children’s hospitals was conducted. A single practitioner from each target hospital was identified through the Children’s Hospital Association. Practice-based survey questions identified whether hospitals utilize EIAG, EIBL, and CIBL dosing.

Main Outcome Measure: The main outcome measure was the percentage utilization of the dosing strategies, with secondary outcomes being the reasons for not using these dosing strategies.

Results: Seventy-seven of 215 identified practitioners (36 %) participated in the survey. EIAG, EIBL, and CIBL dosing were utilized in 63 %, 24 %, and 13 % of responding hospitals, respectively. The most common reasons for not using EIAG were concern regarding lack of efficacy data (56 %) and concern regarding the duration of the drug-free period (41 %). Respondents who did not utilize EIBL cited concern due to lack of pediatric EIBL efficacy data (54 %), the need for more intravenous access (54 %), intravenous medication compatibility issues (39 %), and the time during which the patient is attached to an intravenous infusion (31 %).

Conclusion: This survey of children’s hospitals indicates that EIAG is used in over 50 % of hospitals, but there is some lag in adoption of EIBL and CIBL dosing, both of which are used in fewer than 25 % of hospitals. Additional studies may provide much-needed evidence to increase the utilization of these strategies.

Original languageEnglish
Pages (from-to)523-529
Number of pages7
JournalPediatric Drugs
Volume16
Issue number6
DOIs
StatePublished - Dec 2 2014

Fingerprint

Pediatric Hospitals
Aminoglycosides
Outcome Assessment (Health Care)
Pediatrics
Lactams
Surveys and Questionnaires
Intravenous Infusions

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pharmacology (medical)
  • Medicine(all)

Cite this

Optimized Antimicrobial Dosing Strategies : A Survey of Pediatric Hospitals. / Knoderer, Chad A.; Nichols, Kristen R.; Cox, Elaine.

In: Pediatric Drugs, Vol. 16, No. 6, 02.12.2014, p. 523-529.

Research output: Contribution to journalArticle

Knoderer, Chad A. ; Nichols, Kristen R. ; Cox, Elaine. / Optimized Antimicrobial Dosing Strategies : A Survey of Pediatric Hospitals. In: Pediatric Drugs. 2014 ; Vol. 16, No. 6. pp. 523-529.
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abstract = "Background: Extended-interval aminoglycoside (EIAG) and extended- and continuous-infusion β-lactam (EIBL and CIBL) dosing strategies are increasingly used in adults, but pediatric literature is limited.Objective: The objective of this study was to describe the use of EIAG, EIBL, and CIBL dosing in pediatric hospitals in the USA.Study Design, Setting, and Participants: A national survey of children’s hospitals was conducted. A single practitioner from each target hospital was identified through the Children’s Hospital Association. Practice-based survey questions identified whether hospitals utilize EIAG, EIBL, and CIBL dosing.Main Outcome Measure: The main outcome measure was the percentage utilization of the dosing strategies, with secondary outcomes being the reasons for not using these dosing strategies.Results: Seventy-seven of 215 identified practitioners (36 {\%}) participated in the survey. EIAG, EIBL, and CIBL dosing were utilized in 63 {\%}, 24 {\%}, and 13 {\%} of responding hospitals, respectively. The most common reasons for not using EIAG were concern regarding lack of efficacy data (56 {\%}) and concern regarding the duration of the drug-free period (41 {\%}). Respondents who did not utilize EIBL cited concern due to lack of pediatric EIBL efficacy data (54 {\%}), the need for more intravenous access (54 {\%}), intravenous medication compatibility issues (39 {\%}), and the time during which the patient is attached to an intravenous infusion (31 {\%}).Conclusion: This survey of children’s hospitals indicates that EIAG is used in over 50 {\%} of hospitals, but there is some lag in adoption of EIBL and CIBL dosing, both of which are used in fewer than 25 {\%} of hospitals. Additional studies may provide much-needed evidence to increase the utilization of these strategies.",
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