Evidence map›Paper›PMID 28954790›Full record

ArticleBMJ open2017

Did the accuracy of oral amoxicillin dosing of children improve after British National Formulary dose revisions in 2014? National cross-sectional survey in England.

Olivia Rann, Mike Sharland, Paul Long, Ian C K Wong, Anthony A Laverty, Alex Bottle, Charlotte I Barker, Julia Bielicki, Sonia Saxena

Abstract read
In one paragraph

Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Olivia RannDepartment of Primary Care and Public Health, Imperial College London, London, UK.
Mike SharlandPaediatric Infectious Diseases Research Group, St George's University of London, London, UK.
Paul LongDepartment of Pharmaceutical Science, King's College London, London, UK.
Ian C K WongDepartment of Practice and Policy, University College London, London, UK.
Anthony A LavertyDepartment of Primary Care and Public Health, Imperial College London, London, UK.
Alex BottleDepartment of Primary Care and Public Health, Imperial College London, London, UK.
Charlotte I BarkerPaediatric Infectious Diseases Research Group, St George's University of London, London, UK.
Julia BielickiPaediatric Infectious Diseases Research Group, St George's University of London, London, UK.
Sonia SaxenaDepartment of Primary Care and Public Health, Imperial College London, London, UK.

Funding

Department of Health CDF-2011-04-048
6 · The paper itself

Abstract

objectivesInaccurate 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

participantsWe 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.

interventionsWe 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.

resultsBefore 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.

conclusionsChanges 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.

Indexed as

Pharmacopoeias as TopicAdministration, OralAdolescentAmoxicillinAnti-Bacterial AgentsBody WeightChildChild, PreschoolCross-Sectional StudiesDose-Response Relationship, DrugDrug Dosage CalculationsEnglandHumansInappropriate PrescribingInfantInfant, NewbornAmoxicillinAnti-Bacterial AgentsAge bandsAmoxicillinAntibiotic DosingBritish National FormularyChildrenOral Penicillin

Identifiers

PMID28954790
PMCPMC5623497

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