TABLE 4.
Description of doses and duration of treatment for drugs prescribed as single doses or intermittent administration
| Molecule n=n. patients with intermittent administration/N patients with a prescription of the molecule (%) | Route | Unit dose (dose/kg) | Dose interval (h) (% of patients) | Mean daily dose (dose/kg/d) * | Cumulated dose (dose/kg) * | Duration of treatment (days) * |
|---|---|---|---|---|---|---|
| Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | |||
| Median (IQR) | Median (IQR) | Median (IQR) | Median (IQR) | |||
| p.2.5-p.97.5 | p.2.5-p.97.5 | p.2.5-p.97.5 | p.2.5-p.97.5 | |||
| Acetaminophen (mg/kg) n= 17327/24395 (71.0%) | PO | 13.4 (2.4) | 6h (83%), 8h (21%), 12h (3%), other < 1% | 51 (11.3) | 379 (590) | 8.3 (12.3) |
| 15 (10-15) | 60 (40–60) | 181 (93-414) | 4 (2-9) | |||
| 10–15 | 30–60 | 32–1971 | 1–44 | |||
| Acetaminophen (mg/kg) n=15181/24395 (62.2%) | IV | 11.7 (4.4) | 6h (63%), 12h (30%), 8h (15%), other < 1%, Single dose (14%) | 31.9 (10.2) | 200 (333) | 7.0 (9.9) |
| 10 (10-15) | 30 (25.5–0) | 107 (54–223) | 4 (2-8) | |||
| 7.5–20 | 20–60 | 20-943 | 1–33 | |||
| Opioids | ||||||
| Morphine (µg/kg) n=2034/5213 (39.0%) | PO | 132 (202) | 6 h (61%), 4 h (55%), 8 h (15%), 12 h (11%), 3 h (8%), other <5% | 630 (867) | 5330 (12030) | 8.6 (11.4) |
| 88 (50-167) | 480 (312-800) | 2066 (896 – 4842) | 5 (2-11) | |||
| 12.5 - 500 | 80 - 1947 | 97-32343 | 1 - 34 | |||
| Sufentanil (µg/kg) n=401/6751 (5.9%) | IV | 0.3 (0.61) | Single dose (100%) | |||
| 0.2 (0.2-0.2) | ||||||
| 0.1 – 0.5 | ||||||
| Morphine (µg/kg) n=285/5213 (5.5%) | IV | 41.9 (37.5) | 8h (41%), 4h (27%), 6h (17%), 24h (8%), other <5%, Single dose (11.2%) | 276 (595) | 641.2 (2683) | 2.6 (6.9) |
| 50 (20-50) | 150 (90-250) | 150 (63-360) | 1 (1-2) | |||
| 5 – 120.8 | 11.5 - 1200 | 1.1-3116 | 1 - 8.7 | |||
| Fentanyl (µg/kg) n=29/1141 (2.5%) | IV | 0.9 (0.5) | Single dose (100%) | |||
| 1 (0.5-1) | ||||||
| 0.3 - 2 | ||||||
| Nalbuphine (mg/kg) n=1561/1814 (86.0%) | IV | 0.21 (1.25) | 6h (62%), 4h (5%), other <5%, Single dose (35.2%) | 0.5 (0.3) | 1.2 (1.5) | 2.9 (2.3) |
| 0.2 (0.1-0.2) | 0.4 (0.2-0.8) | 0.8 (0.35-1.4) | 2 (1-3) | |||
| 0.03 - 0.6 | 0.15 - 1.1 | 0.1-5.8 | 1 - 9 | |||
| Nalbuphine (mg/kg) n=300/1814 (16.5%) | IR | 0.2 (0.05) | 6h (90%), 24h (7%), 4h (2%), 8h (<1%), Single dose (3.3 %) | 0.74 (0.18) | 1.7 (2.4) | 2.6 (4.2) |
| 0.2 (0.2-0.2) | 0.8 (0.8-0.8) | 1 (0.8-2.1) | 2 (1-3) | |||
| 0.1 - 0.4 | 0.2 - 0.8 | 0.2-5.8 | 1 – 8.8 | |||
| Sedatives | ||||||
| Midazolam (µg/kg) n=331/6052 (5.5%) | IV | 65.7 (44.5) | 3h (12%), other < 1%, Single dose (86.4 %) | 510.8 (402.3) | 1095 (1670) | 2.6 (2.1) |
| 50 (50-100) | 400 (160-800) | 720 (400-1062) | 2 (1-3) | |||
| 10 - 200 | 52.5 - 1416 | 29 - 4794 | 1 - 9 | |||
| Midazolam (µg/kg) n=25/6052 (0.4%) | PO | 232 (154) | 12 h (68%), 6 h (52%), 3h (8%), 8h (8%), 1 h (< 1%) | 764 (448) | 2727 (2859) | 4.1 (3.5) |
| 200 (105 -300) | 687 (459-1200) | 1200 (613-4717) | 3 (1-6) | |||
| (25 - 578) | 120 - 1511 | 51-8399 | 1 - 11 | |||
| Midazolam (µg/kg) n=136/6052 (2.2%) | IR | 172 (128) | 6 h (1%), 12 h (2%), 3h (<1%), 24h (1%), Single dose (97.1 %) | 233 (121) | 252 (263) | 1.25 (0.5) |
| 150 (100-300) | 220 (175-278) | 161 (76-337) | 1 (1-1.25) | |||
| 10 - 395 | (107 - 380) | 61-599 | 1 - 1.9 | |||
| Midazolam (µg/kg) n=15/6052 (0.2%) | IN | 129 (130) | 6 h (60%), 24 h (40%) | 263.3 (161) | 670 (1646) | 2 (2.8) |
| 100 (90-100) | 220 (100-400) | 304 (100-400) | 1 (1-1.5) | |||
| 41.5 - 500 | 100 - 511 | 38-4443 | 1 - 8.9 | |||
| Hydroxyzine (mg/kg) n=355/359 (98.9%) | PO | 1.1 (0.9) | 12 h (39%), 24 h (26%), 8 h (19%), 6 h (3%), other <1%, Single dose (23.4 %) | 1.2 (0.6) | 11.6 (27) | 9.7 (15.4) |
| 1 (0.5-1) | 1 (1-1.3) | 4 (1.7-11.1) | 4 (2-10.3) | |||
| 0.25 - 4 | 0.5 - 3 | 0.4-70.5 | 1 - 61.4 | |||
| Hydroxyzine (mg/kg) n=8/359 (2.2%) | IV | 1.5 (0.6) | 12h (63%), 8h (12%), Single dose (25 %) | 1.3 (0.8) | 4.3 (2.8) | 3.8 (1.2) |
| 2 (1-2) | 1 (1-1) | 3.5 (2.5-4.7) | 4 (3.3-4.7) | |||
| 0.5 - 2 | 1 - 2.75 | 1.9-8.9 | 2.1 - 5 | |||
| Diazepam (mg/kg) n=20/332 (6.0%) | IV | 0.5 | Single dose (100%) | |||
| Diazepam (mg/kg) n=308/332 (92.8%) | PO | 0.35 (0.53) | 6h (71%), 8h (20%), 4h (13%), 12h (10%), other <5% | 1.0 (0.96) | 7.7 (16.5) | 7.5 (11) |
| 0.25 (0.16-0.33) | 1 (0.66-1) | 2.6 (1.1-6.8) | 3 (2-8) | |||
| 0.08 - 1.8 | 0.27 - 2.6 | 0.4-56 | 1 - 40 | |||
| Diazepam (mg/kg) n=43/332 (13.0%) | IR | 0.5 (0.03) | Single dose (100%) | |||
| 0.5 (0.5-0.5) | ||||||
| 0.5 - 0.5 | ||||||
| Clonidine (µg/kg) n=43/168 (25.6%) | PO | 2.9 (2.3) | 6h (100%), 4h (5%), 12h (5%) | 9.25 (4.2) | 148 (317) | 13.4 (13) |
| 2 (1.5-3.3) | 8 (6.9-9.5) | 69 (47-140) | 9 (6-15) | |||
| 0.5 - 9.0 | 5.4 - 21.5 | 24-336 | 3 - 35 | |||
| Anesthetics | ||||||
| Ketamine (mg/kg) n=3294/3498 (94.2%) | IV | 1.1 (0.6) | Single dose (100%) | |||
| 1 (0.5-2) | ||||||
| 0.5 - 2 | ||||||
| Ketamine (mg/kg) n=109/3498 (3.1%) | IR | 1.1 (1.1) | Single dose (100%) | |||
| 0.5 (0.5-1) | ||||||
| 0.5 – 5 | ||||||
| Ketamine (mg/kg) n=11/3498 (0.3%) | IN | 1.6 (0.5) | Single dose (100%) | |||
| 2 (1-2) | ||||||
| 1 – 2 | ||||||
| Ketamine (mg/kg) n=5/3498 (0.1%) | IM | 5.6 (2.4) | Single dose (100%) | |||
| 5 (5-8) | ||||||
| 2 – 8 | ||||||
| Propofol (mg/kg) n=2079/2131 (97.6%) | IV | 1.1 (0.5) | Single dose (100%) | |||
| 1 (1-1) | ||||||
| 0.5 - 3 | ||||||
| Thiopental (mg/kg) n=33/47 (70.2%) | IV | 2.6 (0.6) | Single dose (100%) | |||
| 2.5 (2.5-3) | ||||||
| 0.5 - 4 | ||||||
| Paralytics | ||||||
| Atracurium (mg/kg) n=270/585 (46.2%) | IV | 0.31 (0.1) | Single dose (100%) | |||
| 0.3 (0.25-0.3) | ||||||
| 0.25 - 0.5 | ||||||
| Suxamethonium (mg/kg) n=103/103 (100%) | IV | 1.5 (0.4) | Single dose (100%) | |||
| 1.5 (1.5-1.5) | ||||||
| 0.6 – 2 | ||||||
| Rocuronium (mg/kg) n=9/23 (39.1%) | IV | 0.8 (0.25) | Single dose (100%) | |||
| 0.85 (0.6-1) | ||||||
| 0.3 - 1 | ||||||
| Vecuronium (mg/kg) n=2/8 (25%) | IV | 0.01 | Single dose (100%) | |||
| Antidotes | ||||||
| Naloxone (µg/kg) n=432/452 (95.6%) | IV | 24.9 (35.3) | Single dose (100%) | |||
| 10 (10-10) | ||||||
| 1 - 100 | ||||||
| Naloxone (µg/kg) n=11/452 (2.5%) | SC | 34.2 (40.7) | Single dose (100%) | |||
| 10 (10-77.5) | ||||||
| 10 - 100 | ||||||
| Naloxone (µg/kg) n=7/452 (1.5%) | IM | 12.1 (7.2) | Single dose (100%) | |||
| 10 (10-10) | ||||||
| 10 - 28 | ||||||
| Flumazenil (µg/kg) n=19/28 (67.9%) | IV | 0.014 (0.01) | Single dose (100%) | |||
| 0.01 (0.01-0.01) | ||||||
| 0.01 - 0.03 | ||||||
*
Mean daily dose, cumulative dose and duration of treatment are described only for intermittent administration.
Doses and duration of treatment are presented as mean (standard deviation), median (interquartile) and 2.5 – 97.5 percentile range (to exclude extreme values).
IV, intravenous; PO, per os; IM, intramuscular; SC, subcutaneous; IN, intranasal.
The total number of patients indicated for each molecule and used to calculate proportions is the total number of patients for whom we had data on dosing regimen.
87 neonates received acetaminophen by rectal route (0.4%) without detailed data on the dose prescribed.