Kevin, M.D. - Medical Weblog: Dosing infants

Monday, March 31, 20083

Dosing infants

Can be tantamount to guesswork.

undisonus

It isn't that confusing. If you're treating a baby and you don't know what the dose is, and you don't know where to find it, then that is probably a sign that you've stepped out of your field of expertise and need a consult.

1:46 PM
RJS

You miss the point, undisonus. Most drugs are not tested on infants, so the correct dosage *is* often tantamount to guesswork.

Flea (I think?) used to talk about how they're just using common sense methods of guessing. Yes, guessing. Because the manufacturer won't study the drug in infants because the liability risks are too great. Therefore it's the peds MD's best guess/experience.

A consult ain't gonna help if there's been no research done.

4:46 PM
undisonus

Well, they used poor examples in the story, then. While it's true there aren't any randomized clinical trials, I imagine the peds ID guys at my hospital aren't the only ones who have figured out how to use fluconazole on babies. And it's long been an AAP recommendation not to give babies OTC cold meds anyway, so why screw around with antihistamines? Just because there isn't any class A evidence doesn't mean that it's completely arbitrary.

12:02 AM