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Penicillin doses for children – which have stayed the same for 50 years – need to be reviewed because youngsters are getting heavier, experts have said.
Dosages are based on age but an average weight is assumed and average weights have risen, the London-based team warn. In the British Medical Journal, they say a review is needed to ensure children are getting enough medication. But one pharmacist said using weight could mean more room for error. Oral penicillins, such as amoxicillin, account for nearly 4.5 million of the
total six million annual prescriptions for antibiotics given to treat childhood bacterial infections each year in the UK. The current dosing guidelines are set out in the British National Formulary for Children.
Experts from King’s College London and St George’s, University of London, say doses on a child’s age was first suggested in the 1950s, and the guidelines medics still use were published in the BMJ in 1963.
“What may have been adequate doses of penicillin 50 years ago are potentially not enough today”
said Dr Paul Long, King’s College London
These estimated that a baby aged up to one weighed 10kg (22lbs), a two-year-old weighed 13kg (28.6lbs), a five-year-old 18kg (39.6lbs) and a 10-year-old 30kg (66.1lbs). However, according to the Health Survey for England 2009, the average weight of a five-year-old has risen to 21kg (46.2lbs) and a 10-year-old is 37kg (81.5lbs), suggesting average weights are up to 20% higher than in 1963.
Dr Paul Long, an expert at King’s College London who was part of the review team, said:
“We were surprised at the lack of evidence to support the current oral penicillins dosing recommendations for children, as it is such a commonly used drug. Children’s average size and weight are slowly but significantly changing, so what may have been adequate doses of penicillin 50 years ago are potentially not enough today.”
He added: “These days new medicines go through very rigorous testing processes, but we seem to forget about the old ones. For adults, penicillin dosages have been reviewed twice in the same period.”
The need for children to take part in more physical activities and exercise is also highlighted by this report. A generation ago kids would be more likely to play outdoors and participate in organised sport. However, many factors, including the popularity of video games, easy access to different forms of media entertainment and more sedentary parents are all contributing to overweight children.