School of Pharmacy, Faculty of Health Sciences & Veterinary Medicine, University of Namibia.
Afr Health Sci. 2022 Sep;22(3):436-441. doi: 10.4314/ahs.v22i3.47.
World Health Organization (WHO) advocates use of weight bands in antiretroviral therapy (ART) guidelines. Allometric scaling could be a more reliable method because it uses a non-linear approach in relating dose to body weight. This study evaluates performance of the allometric ¾ power model in comparison to WHO weight band method in children receiving ART.
Records of children receiving (ABC/3TC) + DTG were reviewed. Paediatric ABC/3TC dose was calculated from the adult dose using the allometric ¾ power model and compared to WHO weight band dose.
WHO weight band strategy grouped 50.6% of the children in the 25 kg category and therefore received the adult dose of ABC/3TC (600 mg/300 mg); only 1.1% received this dose with allometric scaling. Mean dose (3.8 tablets) for the WHO weight band dosing method was found to be significantly higher (p<0.0001) than for allometric scaling (1.5 tablets).
WHO weight bands may result in the 25 kg weight category receiving a much higher dose leading to ADRs. Using allometric scaling, we recommend a weight band strategy that could improve paediatric ABC/3TC dosing.
世界卫生组织(WHO)主张在抗逆转录病毒疗法(ART)指南中使用体重带。比例法可能是一种更可靠的方法,因为它在将剂量与体重相关联时采用了非线性方法。本研究评估了比例法 ¾ 幂模型与 WHO 体重带法在接受 ART 治疗的儿童中的表现。
回顾接受(ABC/3TC)+DTG 治疗的儿童记录。使用比例法 ¾ 幂模型从成人剂量计算儿科 ABC/3TC 剂量,并与 WHO 体重带剂量进行比较。
WHO 体重带策略将 50.6%的儿童归入 25 公斤类别,因此接受成人剂量的 ABC/3TC(600mg/300mg);只有 1.1%的儿童接受比例法剂量。发现 WHO 体重带剂量方法的平均剂量(3.8 片)明显高于比例法(1.5 片)(p<0.0001)。
WHO 体重带可能导致 25 公斤体重类别接受更高的剂量,从而导致不良反应。使用比例法,我们建议采用体重带策略,这可能会改善儿科 ABC/3TC 的剂量。