High variability in the dosing of commonly used antibiotics revealed by a Europe-wide point prevalence study: implications for research and dissemination

Antibiotic dosing in neonates varies between countries and centres, suggesting suboptimal exposures for some neonates. We aimed to describe variations and factors influencing the variability in the dosing of frequently used antibiotics in European NICUs to help define strategies for improvement. A s...

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Bibliographic Details
Published in:BMC pediatrics 2015-04, Vol.15 (1), p.41, Article 41
Main Authors: Metsvaht, Tuuli, Nellis, Georgi, Varendi, Heili, Nunn, Anthony J, Graham, Susan, Rieutord, Andre, Storme, Thomas, McElnay, James, Mulla, Hussain, Turner, Mark A, Lutsar, Irja
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - administration & dosage
Bacterial Infections - drug therapy
Beta lactamases
Drug Administration Schedule
Drug therapy
Europe
Guideline Adherence
Humans
Infant, Newborn
Infants (Newborn)
Intensive Care Units, Neonatal
Practice Guidelines as Topic
Practice Patterns, Physicians
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Summary:Antibiotic dosing in neonates varies between countries and centres, suggesting suboptimal exposures for some neonates. We aimed to describe variations and factors influencing the variability in the dosing of frequently used antibiotics in European NICUs to help define strategies for improvement. A sub-analysis of the European Study of Neonatal Exposure to Excipients point prevalence study was undertaken. Demographic data of neonates receiving any antibiotic on the study day within one of three two-week periods from January to June 2012, the dose, dosing interval and route of administration of each prescription were recorded. The British National Formulary for Children (BNFC) and Neofax were used as reference sources. Risk factors for deviations exceeding ±25% of the relevant BNFC dosage recommendation were identified by multivariate logistic regression analysis. In 89 NICUs from 21 countries, 586 antibiotic prescriptions for 342 infants were reported. The twelve most frequently used antibiotics - gentamicin, penicillin G, ampicillin, vancomycin, amikacin, cefotaxime, ceftazidime, meropenem, amoxicillin, metronidazole, teicoplanin and flucloxacillin - covered 92% of systemic prescriptions. Glycopeptide class, GA
ISSN:1471-2431
1471-2431
DOI:10.1186/s12887-015-0359-y