Penicillin doses for children need to be reviewed, say experts

Call for change in penicillin guidelines comes as children are getting heavier

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The fact that children in the UK are getting heavier means they may not be getting the right amount of medication to fight off bacterial infections, experts have said.

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Penicillin dosages for children have stayed the same for 50 years and are based on children’s ages. But experts from King’s College London and St George’s, University of London, have warned that doses are also determined by an average weight and average weights have increased.

“Children’s average size and weight are slowly but significantly changing, what may have been adequate doses 50 years ago are potentially not enough today,” said Dr Paul Long, a medicines expert at King’s College London who was part of the review team.

In the British Medical Journal (BMJ), the researchers have claimed that a review is needed to make sure children are getting enough.

According to the experts, the child penicillin guidelines that doctors still use were published in the BMJ in 1963, and basing dosages on age was first proposed in the 1950s.

Today, the average weight of a 5-year-old is 21kg (42.2lb) and a 10-year-old is 37kg (81.5lb). This is up to 20% higher than in 1963.

“We were surprised at the lack of evidence to support the current oral penicillins dosing recommendations for childen, as it is such a commonly used drug,” said Dr Paul.

“It is important to point out that this study does not provide any clinical evidence that children are receiving sub-optimal penicillin doses that lead to harm, and we want to reassure parents of that,” Dr Paul explained. “We should ensure that children with severe infections who need these antibiotics the most are still receiving an effective dose,” he added.

In the UK, oral penicillins account for nearly 4.5 million of the total 6 million prescriptions given to treat children’s bacterial infections each year.

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