Development of Best Evidence Dosing Recommendations for Term and Preterm Neonates (NeoDose Project)

Hoop-Sommen, Marika A. de; Zanden, Tjitske M van der; Allegaert, Karel; Flint, Robert B.; Simons, Sinno H P

doi:10.1159/000528012

Cited by 6 publications

(4 citation statements)

References 17 publications

(33 reference statements)

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“…This is of relevance, as it became clear through this work that there are both similarities and dissimilarities in workflow, organization and type of information provided, the knowledge of which may help to direct clinicians to the most appropriate formulary for specific DI. It was therefore quite interesting to notice that this type of information is not easily available in the public domain, although DPF and Swisspeddose have published their workflow and approach, while ANMF describe their workflow and governance on their website [12,13,15,16]. Other formularies provide information on how to use their platform and how it is structured in their own help sections, which are available to subscribers only.…”

Section: Discussionmentioning

confidence: 99%

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Neonatal Drug Formularies: a Global Scope

Shaniv¹,

Bolisetty²,

Young³

et al. 2023

Preprint

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Neonatal drug information (DI) is essential for safe and effective pharmacotherapy in (pre)term neonates. Such information is usually absent from drug labels, making formularies a crucial part of the neonatal clinician’s toolbox. Several formularies exist worldwide, but they have never been fully mapped nor compared for content, structure and workflow. The objective of this review was to identify neonatal formularies, explore (dis)similarities, and raise awareness of their existence.Neonatal formularies were identified through self-acquaintance, experts and structured search. A questionnaire was sent to all identified formularies to provide details on formulary function. An original extraction tool was employed to collect DI from the formularies on the 10 most commonly used drugs in pre(term) neonates.Eight different neonatal formularies were identified worldwide (Europe, USA, Australia-New Zealand, Middle East). Six responded to the questionnaire and were compared for structure and content. Each formulary has its own workflow, monograph template and style, and update routine. Focus on certain aspects of DI also varies, as well as the type of initiative and funding.Clinicians should be aware of the various formularies available and their differences in characteristics and content to use them properly for the benefit of their patients.

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Section: Discussionmentioning

confidence: 99%

“…A dedicated project to further develop the neonatal dosing regimens (NEODOSE) has recently been reported [13].…”

Section: The 'Dutch' Pediatric Formulary (Dpf Also Known As 'Kinderfo...mentioning

confidence: 99%

Neonatal Drug Formularies: a Global Scope

Shaniv¹,

Bolisetty²,

Young³

et al. 2023

Preprint

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“…For neonates and children, the literature supports initial dosing ranges from 3 to 7.5 mg/kg and 4 to 10 mg/kg, respectively, usually given once daily, with subsequent doses determined by TDM [18][19][20][21][22]. The Dutch Pediatric Formulary (DPF) aims to unify prescribing for neonates and children, by providing best evidence-based dosing recommendations, and is currently the national standard for pediatric pharmacotherapy in the Netherlands [23,24]. In the Beatrix Children's Hospital (Beatrix KinderZiekenhuis, BKZ), dosing recommendations of the DPF are followed for children above 1 month of age, while they are not for neonates (Table 1).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Dosing Guidelines for Gentamicin in Neonates and Children

et al. 2023

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Although aminoglycosides are frequently prescribed to neonates and children, the ability to reach effective and safe target concentrations with the currently used dosing regimens remains unclear. This study aims to evaluate the target attainment of the currently used dosing regimens for gentamicin in neonates and children. We conducted a retrospective single-center cohort study in neonates and children receiving gentamicin between January 2019 and July 2022, in the Beatrix Children’s Hospital. The first gentamicin concentration used for therapeutic drug monitoring was collected for each patient, in conjunction with information on dosing and clinical status. Target trough concentrations were ≤1 mg/L for neonates and ≤0.5 mg/L for children. Target peak concentrations were 8–12 mg/L for neonates and 15–20 mg/L for children. In total, 658 patients were included (335 neonates and 323 children). Trough concentrations were outside the target range in 46.2% and 9.9% of neonates and children, respectively. Peak concentrations were outside the target range in 46.0% and 68.7% of neonates and children, respectively. In children, higher creatinine concentrations were associated with higher gentamicin trough concentrations. This study corroborates earlier observational studies showing that, with a standard dose, drug concentration targets were met in only approximately 50% of the cases. Our findings show that additional parameters are needed to improve target attainment.

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“…In a setting of limited resources ('money and people') with emerging new workflows like the benefit-risk assessment of off-label drug use in children (BRAVO) framework or the NEODOSE approach as new approaches, collaboration is very likely needed to really improve the assessment of the available evidence and produce evidence-based data, subsequently converted into bedside clinically useful drug information for neonates [4,5]. Such workflows can be further supported via the integration of physiology-based pharmacokinetics to generate or support dosing recommendations [6].…”

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confidence: 99%