Publication: Healthcare Purchasing News
Date published:
Language: English
PMID: 42714
ISSN: 10983716
Journal code: HCPN

Tailor medicine levels to size and weight, doctors say

With few exceptions, medical practitioners take a one-size-fits-all approach when prescribing drugs to adults, whether the patient is petite or extra large. That is a mistake, according to two doctors writing recently in the medical journal The Lancet. They argue that dosages of antibiotics should be based on a patient's size, with higher doses for heavier patients.

Dr. Matthew E. Falagas, director of the Alfa Institute of Biomedical Sciences in Athens, Greece, and a professor of medicine at Tufts University School of Medicine in Boston, is one of the authors.

Though doses of many cancer drugs are calculated based on body weight because of their toxicity, Dr. Falagas said, there are no guidelines stipulating that doctors should consider a patient's body size when prescribing the vast majority of medications. Prescription patterns that do not take weight into account may be one reason that obese patients are more susceptible to infections after surgery, despite prophylactic use of antibiotics, he suggested.

Changing the way antibiotics are prescribed would enhance their effectiveness and make them safer, and may also reduce the likelihood that microbes will develop resistance to the medications, he said. It would also require drug companies to make more drugs available in liquid form or in several tablet sizes.

Scrubbing backfires on backsides

Rashes from toilet seats on children's buttocks and legs are a growing problem afflicting American children, according to a report in the January 2010 issue of Pediatrics.

Referred to as toilet seat dermatitis, the problem was historically believed to be the result of allergies to certain types of toilet seats such as wooden seats. However, the report concludes that another source, cleaning chemicals and "harsh detergents," are likely causes today.

As to cleaning chemicals specifically, Dr. Bernard A. Cohen, one of the study researchers, concludes that "the incidence of this condition rising in North America is because of the frequent use of detergents that contain highly irritant/sensitizing [chemical] compounds in public restrooms."

Toilet seat dermatitis nearly disappeared in the United States in the 1980s and 1990s. Although multiple reasons were cited for its resurgence, one possibility is that cleaning professionals are using more and stronger cleaning chemicals to clean restroom fixtures due to concerns about H1N1 and the "seasonal" flu this time of year. For more information, visit

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