Optimized Antimicrobial Dosing Strategies: A Survey of Pediatric Hospitals

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

Research output: Contribution to journalArticle

5 Scopus citations


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 (US)
Pages (from-to)523-529
Number of pages7
JournalPediatric Drugs
Issue number6
StatePublished - Dec 2 2014

ASJC Scopus subject areas

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

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