Review of child penicillin doses urged

Experts have said that penicillin doses for children need to be reviewed because youngsters are getting heavier.

Doses for children based on age, with an assumed average weight, have remained unchanged for 50 years.

But because the average weight of children has risen, researchers from King’s College London and St George’s, University of London, say a review is needed to ensure young people are now receiving an adequate dose of penicillin.

Current dose guidelines are set out in the British National Formulary for Children with oral penicillins, such as amoxicillin, accounting for nearly 4.5 million of the total six million annual prescriptions for antibiotics given to treat childhood bacterial infections each year in the UK.

Dr Paul Long, a medicines expert at King’s College London who was part of the review team which has also published its findings in the BMJ, said: “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.

“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.”

During that period, adult penicillin doses have been reviewed on two occasions.

However, the Royal Pharmaceutical Society has urged caution is needed on switching to weight-based dosing for children.

While a good proportion of children would be getting enough medicine under current guidelines, there is a number that probably do not, said spokesman Steve Tomlin.

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