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| Children 'under-dosed' on penicillin | Children 'under-dosed' on penicillin |
| (1 day later) | |
| Millions of children in the UK are being given penicillin at too low a dose, putting them at risk of persistent infections, say researchers. | Millions of children in the UK are being given penicillin at too low a dose, putting them at risk of persistent infections, say researchers. |
| They looked at 65,000 prescriptions given to some 46,000 children in 2010. | They looked at 65,000 prescriptions given to some 46,000 children in 2010. |
| About two-thirds of those aged six to 18 were given suboptimal doses. | About two-thirds of those aged six to 18 were given suboptimal doses. |
| The researchers said most of them would still get better but some could develop complications - though the study published in the British Journal of General Practice did not look at this. | The researchers said most of them would still get better but some could develop complications - though the study published in the British Journal of General Practice did not look at this. |
| The UK work, involving researchers from King's College London and Imperial College London, examined GP prescriptions of oral penicillin drugs, the most commonly prescribed antibiotics for children worldwide. | |
| While nearly all children aged one to five received the recommended dose for their age, 40% of six to 12-year-olds and 70% of 12 to 18-year-olds were given lower doses than those set out in the prescribing manual the British National Formulary for Children. | While nearly all children aged one to five received the recommended dose for their age, 40% of six to 12-year-olds and 70% of 12 to 18-year-olds were given lower doses than those set out in the prescribing manual the British National Formulary for Children. |
| The study authors say prescribing practices needed to be reviewed, especially since youngsters are getting heavier and may need larger doses as a result. | The study authors say prescribing practices needed to be reviewed, especially since youngsters are getting heavier and may need larger doses as a result. |
| And GPs are not necessarily to blame - the paediatric dosing guidelines have remained complicated, with the potential to confuse prescribers, they say. | And GPs are not necessarily to blame - the paediatric dosing guidelines have remained complicated, with the potential to confuse prescribers, they say. |
| 'More health contacts' | 'More health contacts' |
| The British National Formulary for Children recommends different doses of penicillin depending on the individual drug and the condition being treated. For some conditions it gives a dose recommendation by weight, for others it is by age group. | The British National Formulary for Children recommends different doses of penicillin depending on the individual drug and the condition being treated. For some conditions it gives a dose recommendation by weight, for others it is by age group. |
| Dr Sonia Saxena, co-author from Imperial College London who is also a GP, said: "It is important now to understand why GPs are prescribing sub-therapeutic levels of penicillin. Some GPs may be erring on the side of caution, prescribing low doses to avoid errors or side-effects. | Dr Sonia Saxena, co-author from Imperial College London who is also a GP, said: "It is important now to understand why GPs are prescribing sub-therapeutic levels of penicillin. Some GPs may be erring on the side of caution, prescribing low doses to avoid errors or side-effects. |
| "In the majority of cases children will still get better, but under-treating those children who do need antibiotics could mean more infectious complications and more health contacts overall." | "In the majority of cases children will still get better, but under-treating those children who do need antibiotics could mean more infectious complications and more health contacts overall." |
| Inappropriate use of antibiotics also increases the chance of drug resistance developing. | Inappropriate use of antibiotics also increases the chance of drug resistance developing. |
| Steve Tomlin of the Royal Pharmaceutical Society said the research raised important questions, but did not provide the answers. | Steve Tomlin of the Royal Pharmaceutical Society said the research raised important questions, but did not provide the answers. |
| "It raises the fundamental question about whether we are dosing appropriately for children based on age. Perhaps we need to be looking at the individual weight of a child and dosing accordingly, but those sorts of calculations can go wrong and are not without risk. | "It raises the fundamental question about whether we are dosing appropriately for children based on age. Perhaps we need to be looking at the individual weight of a child and dosing accordingly, but those sorts of calculations can go wrong and are not without risk. |
| "The way forward is not clear. We need to look at the dosing bands and see if they are right or if they need to change." | "The way forward is not clear. We need to look at the dosing bands and see if they are right or if they need to change." |