Discipline of Pharmacology, Sydney Medical School, Translational Australian Clinical Toxicology Program, The University of Sydney, NSW, Australia, 2006.
Br J Clin Pharmacol. 2018 May;84(5):1029-1037. doi: 10.1111/bcp.13511. Epub 2018 Feb 21.
This study investigates paediatric drug dosage guidelines with the aim of investigating their agreement with body surface area (BSA) scaling principles.
A total of 454 drug dosage guidelines listed in the AMH-CDC 2015 were examined. Data extracted included the administration, frequency and dose per age bracket from 0 to 18 years. Drug treatments were categorized as follows: (1) The same dose recommendation in milligrams per kilogram (mg kg ) for all age/weights; (2) Change in the mg kg dosing according to age/weight; (3) Change in dose in mg according to age/weight; (4) Change from mg kg dosing to a dose in mg according to age/weight; (5) The same recommendation for all age/weight groups in mg; or (6) BSA dosing. Example drugs were selected to illustrate dose progression across ages.
Most drug treatments (63%) have the same mg kg dose for all age/weight groups, 14% are dosed in mg kg across all ages with dose changes according to age/weight, 13% were dosed in mg across all ages with dose changes, 10% switched from mg kg to a set dose in mg, 4.2% have the same dose in mg for all age and weight groups and 2.2% are dosed according to BSA.
Paediatric dosage guidelines are based on weight-based formulas, available dosing formulations and prior patterns of use. Substantial variation from doses predicted by BSA scaling are common, as are large shifts in recommended doses at age thresholds. Further research is required to determine if better outcomes could be achieved by adopting biologically based scaling of paediatric doses.
本研究旨在调查儿科药物剂量指南，以调查其与体表面积（BSA）缩放原则的一致性。
共检查了 2015 年 AMH-CDC 列出的 454 种药物剂量指南。提取的数据包括从 0 至 18 岁的每个年龄组的给药、频率和剂量。药物治疗分为以下几类：（1）所有年龄/体重的毫克/千克（mg/kg）相同剂量建议；（2）根据年龄/体重改变 mg/kg 剂量；（3）根据年龄/体重改变剂量；（4）根据年龄/体重从 mg/kg 剂量改为 mg 剂量；（5）所有年龄/体重组的相同 mg 推荐剂量；或（6）BSA 剂量。选择示例药物来说明剂量在年龄之间的进展。
大多数药物治疗（63%）对所有年龄/体重组具有相同的 mg/kg 剂量，14% 在所有年龄段以 mg/kg 剂量给药，剂量根据年龄/体重变化，13% 在所有年龄段以 mg 剂量给药，剂量变化，10% 从 mg/kg 切换到 mg 的固定剂量，4.2% 所有年龄和体重组的剂量相同，2.2% 根据 BSA 给药。
儿科剂量指南基于基于体重的公式、可用的给药配方和先前的使用模式。与 BSA 缩放预测的剂量有很大差异是常见的，在年龄阈值处推荐剂量的大幅变化也是常见的。需要进一步研究以确定通过采用基于生物学的儿科剂量缩放是否可以获得更好的结果。
