Can de facto Dosing Practices Bridge the Knowledge Gap in Pediatric Medication Recommendations

A knowledge gap exists in pediatric medication dosing recommendations due in part to the complexity of researching medication efficacy and safety in children. One possible resource resides in the electronic prescribing practices of pediatric clinicians. In this study, de facto pediatric weight-based levothyroxine dosing practices were studied as a potential source for pediatric medication clinical decision support. This was accomplished by extracting physical exam and prescription details from a well-used clinical data warehouse to calculate weight-based dosing practices, and comparing the results with established medication recommendations. Of the 854 prescriptions, 85.2% were under the recommended range, 9.37% were within the range and 5.39% were over the range. Thus, real world prescribing practices may differ from recommendations. Such information may be a valuable resource in pediatric clinical decision support, particularly where practice differs from recommendations, and can help close the knowledge gap where pediatric medication dosing information is sparse or unavailable.