PT  - JOURNAL ARTICLE
AU  - Stéphanie Leroux
AU  - Wei Zhao
AU  - Pierre Bétrémieux
AU  - Patrick Pladys
AU  - Elie Saliba
AU  - Evelyne Jacqz-Aigrain
AU  - on behalf of the French Society of Neonatology
TI  - Therapeutic guidelines for prescribing antibiotics in neonates should be evidence-based: a French national survey
AID  - 10.1136/archdischild-2014-306873
DP  - 2015 Apr 01
TA  - Archives of Disease in Childhood
PG  - 394--398
VI  - 100
IP  - 4
4099  - http://adc.bmj.com/content/100/4/394.short
4100  - http://adc.bmj.com/content/100/4/394.full
SO  - Arch Dis Child2015 Apr 01; 100
AB  - Objective This survey aims to describe and analyse the dosage regimens of antibiotics in French neonatal intensive care units (NICUs).Methods Senior doctors from 56 French NICUs were contacted by telephone and/or email to provide their local guidelines for antibiotic therapy.Results 44 (79%) NICUs agreed to participate in this survey. In total, 444 dosage regimens were identified in French NICUs for 41 antibiotics. The number of different dosage regimens varied from 1 to 32 per drug (mean 9, SD 7.8). 37% of intravenous dosage regimens used a unique mg/kg dose from preterm to full-term neonates. Doses and/or dosing intervals varied significantly for 12 antibiotics (amikacin, gentamicin, netilmicin, tobramycin, vancomycin administered as continuous infusion, ceftazidime, cloxacillin, oxacillin, penicillin G, imipenem/cilastatin, clindamycin and metronidazole). Among these antibiotics, 6 were used in more than 70% of local guidelines and had significant variations in (1) maintenance daily doses for amikacin, imipenem/cilastatin, ceftazidime and metronidazole; (2) loading doses for continuous infusion of vancomycin; and (3) dosing intervals for gentamicin and amikacin.Conclusions A considerable inter-centre variability of dosage regimens of antibiotics exists in French NICUs. Developmental pharmacokinetic–pharmacodynamic studies are essential for the evaluation of antibiotics in order to establish evidence-based dosage regimens for effective and safe administration in neonates.