Chad A Knoderer1, Kristen R Nichols, Elaine G Cox. 1. Department of Pharmacy Practice, College of Pharmacy and Health Sciences, Butler University, 4600 Sunset Ave., Indianapolis, IN, 46208, USA, cknodere@butler.edu.
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.
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.
Authors: Kevin J Downes; Andrea Hahn; Jason Wiles; Joshua D Courter; Alexander A Vinks Journal: Int J Antimicrob Agents Date: 2013-12-17 Impact factor: 5.283
Authors: Pranita D Tamma; Alison E Turnbull; Aaron M Milstone; Alice J Hsu; Karen C Carroll; Sara E Cosgrove Journal: Clin Infect Dis Date: 2012-06-13 Impact factor: 9.079
Authors: Xuan Qin; Danielle M Zerr; Scott J Weissman; Janet A Englund; Donna M Denno; Eileen J Klein; Phillip I Tarr; Justin Kwong; Jennifer R Stapp; Luis G Tulloch; Emmanouil Galanakis Journal: Antimicrob Agents Chemother Date: 2008-09-02 Impact factor: 5.191
Authors: Despina G Contopoulos-Ioannidis; Nikos D Giotis; Dimitra V Baliatsa; John P A Ioannidis Journal: Pediatrics Date: 2004-07 Impact factor: 7.124