Dose-banding of intravenous piperacillin-tazobactam in pediatric surgical inpatients
© Published by the Pediatric Pharmacy Advocacy Group. All rights reserved. BACKGROUND Antimicrobial doses in children are often prescribed by using an individually calculated dose per weight (e.g., mg/kg) or based on body surface area. Dosing errors are the most commonly reported medication errors i...
| Main Authors: | , , , , |
|---|---|
| Format: | Journal Article |
| Published: |
2017
|
| Online Access: | http://hdl.handle.net/20.500.11937/66541 |
| _version_ | 1848761346762473472 |
|---|---|
| author | Karande, I. Goff, Z. Kewley, J. Mehta, S. Snelling, Thomas |
| author_facet | Karande, I. Goff, Z. Kewley, J. Mehta, S. Snelling, Thomas |
| author_sort | Karande, I. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | © Published by the Pediatric Pharmacy Advocacy Group. All rights reserved. BACKGROUND Antimicrobial doses in children are often prescribed by using an individually calculated dose per weight (e.g., mg/kg) or based on body surface area. Dosing errors are the most commonly reported medication errors in children. A “dose-banding” strategy is frequently used for some over-the-counter drugs to prevent dosing errors. It could also lead to efficiencies by enabling batch preparation of intravenous (IV) medications in hospitals. OBJECTIVES To evaluate whether use of dose-banding for IV piperacillin-tazobactam results in acceptable dose variation from standard practice of individualized prescription of 100 mg/kg in children. METHODS We conducted a historically controlled intervention study comparing prescriptions of IV piperacillin-tazobactam before vs. after introduction of dose-banding prescribing guidance for surgical inpatients weighing > 5 kg and < 16 years of age at the tertiary referral pediatric hospital in Western Australia. RESULTS Dose-banding of IV piperacillin-tazobactam (with a maximum of 15% departure from the recommended milligram-per-weight dose of 100 mg/kg) resulted in similar overall variation of prescribed dose in comparison to individualized milligram-per-weight (non-dose-banded) prescribing. There was a trend toward fewer prescriptions with large variance ( > 30% variation from the 100-mg/kg dose) in the dose-banded compared to the non-dose-banded group (1/140 vs. 5/105; p = 0.09). CONCLUSIONS Our study showed dose-banding of IV piperacillin-tazobactam resulted in acceptable variation when compared to individualized milligram-per-weight dosing in children. Prospectively designed controlled trials are warranted to determine whether dose-banding could reduce medication errors and optimize use of hospital resources. Implications for future practice could include faster batch preparation, shorter checking and dispensing time, and reduction in drug wastage. |
| first_indexed | 2025-11-14T10:30:13Z |
| format | Journal Article |
| id | curtin-20.500.11937-66541 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T10:30:13Z |
| publishDate | 2017 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-665412018-04-30T02:49:04Z Dose-banding of intravenous piperacillin-tazobactam in pediatric surgical inpatients Karande, I. Goff, Z. Kewley, J. Mehta, S. Snelling, Thomas © Published by the Pediatric Pharmacy Advocacy Group. All rights reserved. BACKGROUND Antimicrobial doses in children are often prescribed by using an individually calculated dose per weight (e.g., mg/kg) or based on body surface area. Dosing errors are the most commonly reported medication errors in children. A “dose-banding” strategy is frequently used for some over-the-counter drugs to prevent dosing errors. It could also lead to efficiencies by enabling batch preparation of intravenous (IV) medications in hospitals. OBJECTIVES To evaluate whether use of dose-banding for IV piperacillin-tazobactam results in acceptable dose variation from standard practice of individualized prescription of 100 mg/kg in children. METHODS We conducted a historically controlled intervention study comparing prescriptions of IV piperacillin-tazobactam before vs. after introduction of dose-banding prescribing guidance for surgical inpatients weighing > 5 kg and < 16 years of age at the tertiary referral pediatric hospital in Western Australia. RESULTS Dose-banding of IV piperacillin-tazobactam (with a maximum of 15% departure from the recommended milligram-per-weight dose of 100 mg/kg) resulted in similar overall variation of prescribed dose in comparison to individualized milligram-per-weight (non-dose-banded) prescribing. There was a trend toward fewer prescriptions with large variance ( > 30% variation from the 100-mg/kg dose) in the dose-banded compared to the non-dose-banded group (1/140 vs. 5/105; p = 0.09). CONCLUSIONS Our study showed dose-banding of IV piperacillin-tazobactam resulted in acceptable variation when compared to individualized milligram-per-weight dosing in children. Prospectively designed controlled trials are warranted to determine whether dose-banding could reduce medication errors and optimize use of hospital resources. Implications for future practice could include faster batch preparation, shorter checking and dispensing time, and reduction in drug wastage. 2017 Journal Article http://hdl.handle.net/20.500.11937/66541 10.5863/1551-6776-22.5.364 restricted |
| spellingShingle | Karande, I. Goff, Z. Kewley, J. Mehta, S. Snelling, Thomas Dose-banding of intravenous piperacillin-tazobactam in pediatric surgical inpatients |
| title | Dose-banding of intravenous piperacillin-tazobactam in pediatric surgical inpatients |
| title_full | Dose-banding of intravenous piperacillin-tazobactam in pediatric surgical inpatients |
| title_fullStr | Dose-banding of intravenous piperacillin-tazobactam in pediatric surgical inpatients |
| title_full_unstemmed | Dose-banding of intravenous piperacillin-tazobactam in pediatric surgical inpatients |
| title_short | Dose-banding of intravenous piperacillin-tazobactam in pediatric surgical inpatients |
| title_sort | dose-banding of intravenous piperacillin-tazobactam in pediatric surgical inpatients |
| url | http://hdl.handle.net/20.500.11937/66541 |