{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T13:54:23Z","timestamp":1736776463292,"version":"3.33.0"},"reference-count":0,"publisher":"Canadian Society of Healthcare-Systems Pharmacy","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJHP"],"abstract":"<p><strong>ABSTRACT<\/strong><\/p><p><strong>Background: <\/strong>The use of high-dose, extended-interval aminoglycosides, a common practice in adult populations, is less well established for pediatric patients. In younger populations, these drugs are often administered according to a multiple daily dosing method.<\/p><p><strong>Objective: <\/strong>To characterize prescribing practices for aminoglycosides in pediatric inpatients across Canada, with a focus on high-dose, extended interval regimens.<\/p><p><strong>Methods: <\/strong>This study was based on an electronic survey of pharmacists representing Canadian health care delivery organizations that provided pediatric inpatient services, which was distributed in March 2015. Questions focused on demographic characteristics; indications for highdose, extended-interval tobramycin or gentamicin; use of these regimens in patients with particular comorbidities; empiric dosing; monitoring parameters; and the extent of pharmacists\u2019 authority to independently prescribe doses and order monitoring parameters for aminoglycosides at their respective institutions.<\/p><p><strong>Results: <\/strong>Forty-five (48%) of the 94 prospective participants responded to the survey. Of these 45 respondents, 35 (78%) indicated that their respective health regions used high-dose, extended-interval tobramycin or gentamicin in pediatric inpatients. The patient characteristics for use of such regimens were varied. The median reported doses were 10 mg\/kgfor pulmonary exacerbation in cystic fibrosis, 7 mg\/kg for urinary tract infection, and 8 mg\/kg for febrile neutropenia. Thirty-one (89%) of the 35 respondents using these regimens reported that they monitored serum levels, and 27 (77%) reported monitoring for nephrotoxicity. With regard to prescriptive authority, 7 (16%) of the 45 respondents indicated that pharmacists were authorized to independently adjust dosing at their institutions, and pharmacists at 14 (31%) of 45 sites were authorized to order monitoring parameters.<\/p><p><strong>Conclusions: <\/strong>High-dose, extended-interval aminoglycoside therapy was frequently used for pediatric patients across Canada, although the dosages and monitoring practices varied greatly. The information from this study can be used for cross-comparison of practice by other centres across Canada.<\/p><p><strong>R\u00c9SUM\u00c9<\/strong><\/p><p><strong>Contexte : <\/strong>L\u2019utilisation de doses \u00e9lev\u00e9es d\u2019aminosides administr\u00e9es \u00e0 intervalle prolong\u00e9 est une pratique r\u00e9pandue chez l\u2019adulte, mais moins bien \u00e9tablie chez l\u2019enfant. Dans les populations plus jeunes, ces m\u00e9dicaments sont souvent donn\u00e9s selon une m\u00e9thode d\u2019administration multiquotidienne.<\/p><p><strong>Objectif : <\/strong>Offrir un portrait des habitudes de prescription d\u2019aminosides chez des enfants hospitalis\u00e9s \u00e0 l\u2019\u00e9chelle du Canada en accordant une attention aux sch\u00e9mas posologiques avec administration d\u2019une dose \u00e9lev\u00e9e \u00e0 intervalle prolong\u00e9.<\/p><p><strong>M\u00e9thodes : <\/strong>La pr\u00e9sente \u00e9tude s\u2019appuie sur une enqu\u00eate \u00e9lectronique r\u00e9alis\u00e9e en mars 2015 aupr\u00e8s de pharmaciens repr\u00e9sentant des organisms canadiens de prestation de soins de sant\u00e9 qui offrent des services d\u2019hospitalisation pour les enfants. Les questions portaient sur : les caract\u00e9ristiques d\u00e9mographiques; les indications pour les doses \u00e9lev\u00e9es \u00e0 intervalle posologique prolong\u00e9 de gentamicine ou de tobramycine; l\u2019emploi de ces sch\u00e9mas chez les patients atteints de certaines comorbidit\u00e9s; les posologies empiriques; les param\u00e8tres de surveillance; et l\u2019\u00e9tendue du droit que d\u00e9tiennent les pharmaciens de prescrire les doses d\u2019aminosides de fa\u00e7on ind\u00e9pendante et les param\u00e8tres de surveillance connexes dans leurs \u00e9tablissements respectifs.<\/p><p><strong>R\u00e9sultats : <\/strong>Quarante-cinq (48 %) des 94 potentiels participants ont r\u00e9pondu au sondage. Parmi les 45 r\u00e9pondants, 35 (78 %) ont indiqu\u00e9 que leur r\u00e9gie r\u00e9gionale de la sant\u00e9 faisait l\u2019emploi de sch\u00e9mas avec administration d\u2019une dose \u00e9lev\u00e9e \u00e0 intervalle prolong\u00e9 de tobramycine ou de gentamicine chez des enfants hospitalis\u00e9s. Les caract\u00e9ristiques des patients pour l\u2019utilisation de tels sch\u00e9mas variaient. Les doses medians signal\u00e9es \u00e9taient de 10 mg\/kg pour les exacerbations pulmonaires li\u00e9es \u00e0 une fibrose kystique, de 7 mg\/kg pour les infections urinaires et de 8 mg\/kg pour les neutrop\u00e9nies f\u00e9briles. Trente et un (89 %) des 35 r\u00e9pondants utilisant ces sch\u00e9mas ont indiqu\u00e9 qu\u2019ils surveillaient les taux s\u00e9riques et 27 (77 %) ont signal\u00e9 exercer un suivi pour d\u00e9celer une n\u00e9phrotoxicit\u00e9. En ce qui touche au droit de prescrire, 7 (16 %) des 45 r\u00e9pondants ont indiqu\u00e9 que les pharmaciens \u00e9taient autoris\u00e9s \u00e0 modifier eux-m\u00eames la posologie dans leurs \u00e9tablissements et des pharmaciens dans 14 (31 %) des 45 \u00e9tablissements \u00e9taient autoris\u00e9s \u00e0 prescrire des param\u00e8tres de surveillance.<\/p><p><strong>Conclusions : <\/strong>Les traitements par aminosides avec administration d\u2019une dose \u00e9lev\u00e9e \u00e0 intervalle prolong\u00e9 \u00e9taient fr\u00e9quemment utilis\u00e9s pour les enfants partout au Canada, mais les posologies et les habitudes de surveillance variaient beaucoup. L\u2019information contenue dans la pr\u00e9sente \u00e9tude peut servir \u00e0 faire la comparaison des habitudes au sein d\u2019autres centres \u00e0 l\u2019\u00e9chelle du Canada.<\/p><\/jats:p>","DOI":"10.4212\/cjhp.v69i5.1591","type":"journal-article","created":{"date-parts":[[2016,10,31]],"date-time":"2016-10-31T14:57:13Z","timestamp":1477925833000},"source":"Crossref","is-referenced-by-count":1,"title":["High-Dose, Extended-Interval Gentamicin and Tobramycin for Pediatric Inpatients: A Survey of Canadian Hospital Pharmacists"],"prefix":"10.4212","volume":"69","author":[{"given":"Caitlin","family":"Roy","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn","family":"Gray","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Ruda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Bell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Bolt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2732","published-online":{"date-parts":[[2016,10,31]]},"container-title":["The Canadian Journal of Hospital Pharmacy"],"original-title":[],"link":[{"URL":"http:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/viewFile\/1591\/2414","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/viewFile\/1591\/2434","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/viewFile\/1591\/2415","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/viewFile\/1591\/2414","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"http:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/viewFile\/1591\/2434","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"http:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/viewFile\/1591\/2415","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2016,10,31]],"date-time":"2016-10-31T14:57:16Z","timestamp":1477925836000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/view\/1591"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10,31]]},"references-count":0,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2016,10,31]]}},"URL":"https:\/\/doi.org\/10.4212\/cjhp.v69i5.1591","relation":{},"ISSN":["1920-2903","0008-4123"],"issn-type":[{"type":"electronic","value":"1920-2903"},{"type":"print","value":"0008-4123"}],"subject":[],"published":{"date-parts":[[2016,10,31]]}}}