Penicillin Doses: Report Calls for Revised Children’s Guidelines

A report by the Daily Telegraph indicated that penicillin doses for young children and teenagers may need to be increased, as children and teens are now heavier overall than they have been in past years.

According to the report, guidelines for childhood doses of penicillin, including antipseudomonal and semi-synthetic penicillin, as well as other related antibiotics, have remained unchanged for close on 50 years. These doses are based on children’s ages rather than their weight. The Telegraph’s report is based on a review of how adult penicillin guidelines, in contrast, have changed numerous times over the past 60 years.

The Report

Researchers from the following sources conducted the penicillin dosage report:

• King’s College London,
• The University of London,
• The University of Athens,
• The University of Hong Kong, and
• The prominent UK chemist Boots.

The report was then published in the British Medical Journal. The BBC responded with appropriate media coverage, outlining the pros and cons of changing the penicillin dosing guidelines for children. The Telegraph discussed the issue of children becoming increasingly obese, while the review mentioned changes in growth patterns as well.

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The Findings

Essentially the report indicates that penicillin doses for children are currently too low. At the moment, the British National Formulary for Children prescribes penicillin depending on the specific drug and the condition of the patient. Occasionally a recommendation considers weight (as in the use of amoxicillin for treating ear infections), but for the most part, age is the primary variable (as in the use of amoxicillin for treating urinary tract infections). Antibiotic resistance is an increasing concern with doctors and medical services around the world, and much of this can be attributed to the inappropriate use of the medication, and penicillin doses being too low.

The Result

The authors of the review are calling for a re-evaluation of children’s doses for penicillin based on this empirical evidence so that the correct treatments can be administered. It is suggested in the review that currently, the doses being given to children are ineffective. This, in turn, can compromise the treatment and negatively affect antibiotic resistance. For example, in an instance where a penicillin dose is useless, it allows the bacteria to adapt to the drug. In worse case scenarios, strains of bacteria develop that are immune to standard antibiotics.

On the other hand, giving larger doses than necessary can result in toxicity. Thus the report also suggests that any change in clinical guidelines must consider the appropriate treatments for individual children and be accompanied by instructions that are easy to follow.