Evaluation of Physicians’ Dosing Procedures for Obese Pediatric Populations and Pharmacokinetics of Aminoglycosides in these Patients

• Main Authors: McKee, Megan, McLeod, Melanie, Wicks, Laura
• Other Authors: Murphy, John
• Language: en_US
• Published: The University of Arizona. 2008
• Subjects: Pediatric Obesity; Dosing Procedures; Aminoglycosides
• Online Access: http://hdl.handle.net/10150/624298; http://arizona.openrepository.com/arizona/handle/10150/624298

Class of 2008 Abstract === Objectives: This was a retrospective chart review and survey of pediatric residents. This study aimed to examine standards for aminoglycosides in obese pediatrics; increase awareness of drug monitoring in obese populations; and reduce medication errors. Methods: 101 patients aged three to seventeen that received aminoglycoside treatment were included. Subjects were divided into three groups based on weight and height percentiles as defined by growth charts. Collecting retrospective data provided measured concentrations of aminoglycosides in order to evaluate pharmacokinetics. Data collected included: dose and frequency; time dose was given; length of infusion; two measured concentrations (peak and trough); and time concentration was measured. ANOVA allowed comparisons between aminoglycoside volumes of distribution to weight (based on specific weight groups). Tukey’s post hoc analysis further tested the significance of the pair-wise comparisons (p<0.05). Secondly, a questionnaire was administered to 26 pediatric medical residents at University Medical Center to assess current treatment protocols and attitudes towards medication dosing in obese pediatric patients. Results: The volume of distribution was not significantly different between normal weight and overweight patients (p=0.927); normal weight and obese patients (p=0.174); or overweight and obese patients (p=0.211). Most (81.8%) study participants have some difficulty finding references on dosing in overweight and obese patients. Conclusions: The positive correlation between volume of distribution and total body weight was not statistically significant. Pediatric residents agree that there is a lack of resources regarding obese pediatric medication dosing. Further research is warranted to ensure the reliability and validity of aminoglycoside dosing in obese children.