Scientists and clinicians are saying that there needs to be a review of penicillin dosing guidelines for children.
Current guidelines for penicillin use in children have remained unchanged for nearly 50 years.
A new study published in the British Medical Journal found that some children may not be receiving effective doses, which could potentially lead to failed treatment and contribute to antibiotic resistance.
Oral penicillins account for about 4.5 million of the total 6 million annual prescriptions for antibiotics given to treat childhood bacterial infections each year.
Current UK dosing guidelines for penicillin are provided by the British National Formulary for Children (BNFC) and are mainly based on ages.
The doses recommended have not changed in almost 50 years, and the guidelines do not take into account the increase in the average weight of children over time.
Experts say reviewing these guidelines are essential in order to ensure all children who require penicillin are receiving effective doses.
Researchers found that the age guidelines set in 1963 were accompanied by average weights, and doses are based on fractions of the widely used adult doses.
The structured dosing are not based on current weight values, which are up 20 percent compared to those in 1963. Under-dosing a child could lead to sub-therapeutic concentrations.
Researchers also said that adult penicillin recommendations have been re-evaluated to take modern weights into consideration.
“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,” Dr Paul Long, Senior Lecturer in Pharmacognosy at King’s College London, said in a press release.
“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.”
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