Imperial College London
Alternate

Alex Bottle

Faculty of Medicine, School of Public Health

Professor of Medical Statistics
 
 
 
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Contact

 

+44 (0)20 7594 0913robert.bottle Website

 
 
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Location

 

3 Dorset Rise, London EC4Y 8ENCharing Cross HospitalCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Rann:2017:10.1136/bmjopen-2017-016363,
author = {Rann, O and Sharland, M and Long, P and Wong, I and Laverty and Bottle and Barker, C and Bielicki, J and Saxena, S},
doi = {10.1136/bmjopen-2017-016363},
journal = {BMJ Open},
title = {Did the accuracy of oral amoxicillin dosing of children improve after British National Formulary dose revisions in 2014?: national cross sectional survey in England},
url = {http://dx.doi.org/10.1136/bmjopen-2017-016363},
volume = {7},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objectives Inaccurate antibiotic dosing can lead to treatment failure, fuel antimicrobial resistance and increase side effects. The British National Formulary for Children (BNFC) guidance recommends oral antibiotic dosing according to age bands as a proxy for weight. Recommended doses of amoxicillin for children were increased in 2014 ‘after widespread concerns of under dosing’. However, the impact of dose changes on British children of different weights is unknown, particularly given the rising prevalence of childhood obesity in the UK. We aimed to estimate the accuracy of oral amoxicillin dosing in British children before and after the revised BNFC guidance in 2014.Setting and participants We used data on age and weights for 1556 British children (aged 2–18 years) from a nationally representative cross-sectional survey, the Health Survey for England 2013.Interventions We calculated the doses each child would receive using the BNFC age band guidance, before and after the 2014 changes, against the ‘gold standard’ weight-based dose of amoxicillin, as per its summary of product characteristics.Primary outcome measure Assuming children of different weights were equally likely to receive antibiotics, we calculated the percentage of the children who would be at risk of misdosing by the BNFC age bands.Results Before 2014, 54.6% of children receiving oral amoxicillin would have been underdosed and no child would have received more than the recommended dose. After the BNFC guidance changed in 2014, the number of children estimated as underdosed dropped to 5.8%, but 0.5% of the children would have received too high a dose.Conclusions Changes to the BNFC age-banded amoxicillin doses in 2014 have significantly reduced the proportion of children who are likely to be underdosed, with only a minimal rise in the number of those above the recommended range.
AU  - Rann,O
AU  - Sharland,M
AU  - Long,P
AU  - Wong,I
AU  - Laverty
AU  - Bottle
AU  - Barker,C
AU  - Bielicki,J
AU  - Saxena,S
DO  - 10.1136/bmjopen-2017-016363
PY  - 2017///
SN  - 2044-6055
TI  - Did the accuracy of oral amoxicillin dosing of children improve after British National Formulary dose revisions in 2014?: national cross sectional survey in England
T2  - BMJ Open
UR  - http://dx.doi.org/10.1136/bmjopen-2017-016363
UR  - http://hdl.handle.net/10044/1/50278
VL  - 7
ER  -
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