Hello,

Hoping all is well. Wanted to reach out to peds colleagues to ask your thoughts on how you guide providers on neonatal/pediatric dosing. I ask because we are currently reviewing our own guidelines on dosing medications for neonates in our hospital. Because we are a teaching institution, and we try to keep things standardized, but when the discussion came up about creating hyperlinks for for drug references within out order composer for medications, it was highlighted that many times gestational ages are questionable and that the various resources contain different dosing strategies.

For example, Neofax has multiple dosing charts for Amikacin dosing (Postnatal age/weight based dosing vs. postnatal age/postmenstrual age dosing) and Redbook uses gestational age and postnatal age. Dosing recommendations are different in each. One of our residents recently did an MUE on Amikacin dosing in our NICU and found some interesting results regarding dosing (patients being underdosed considering the high percentage of subtherapeutic peaks) that led to us adjusting dosing and taking a look at the references that were being used for dosing.

Looking forward to your feedback.

Jameika