Dose-Banding of Intravenous Piperacillin-Tazobactam in Pediatric Surgical Inpatients

I. S. Karande, Z. Goff, J. Kewley, S. Mehta, T. Snelling

    Research output: Contribution to journalArticlepeer-review


    Background: Antimicrobial doses in children are often prescribed by using an individually calculated dose per weight (e.g., mg/kg) or based on body surface area. Dosing errors are the most commonly reported medication errors in children. A "dose-banding" strategy is frequently used for some over-the-counter drugs to prevent dosing errors. It could also lead to efficiencies by enabling batch preparation of intravenous (IV) medications in hospitals. 

    Objectives: To evaluate whether use of dose-banding for IV piperacillin-tazobactam results in acceptable dose variation from standard practice of individualized prescription of 100 mg/kg in children. 

    Methods: We conducted a historically controlled intervention study comparing prescriptions of IV piperacillin-tazobactam before vs. after introduction of dose-banding prescribing guidance for surgical inpatients weighing >5 kg and 30% variation from the 100-mg/kg dose) in the dose-banded compared to the non-dose-banded group (1/140 vs. 5/105; p = 0.09). 

     Our study showed dose-banding of IV piperacillin-tazobactam resulted in acceptable variation when compared to individualized milligram-per-weight dosing in children. Prospectively designed controlled trials are warranted to determine whether dose-banding could reduce medication errors and optimize use of hospital resources. Implications for future practice could include faster batch preparation, shorter checking and dispensing time, and reduction in drug wastage.

    Original languageEnglish
    Pages (from-to)364-368
    Number of pages5
    JournalThe journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG
    Issue number5
    Publication statusPublished - 1 Sep 2017


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