Antibiotic dosage in trachoma control programs: height as a surrogate for weight in children.
OBJECTIVE
National programs for trachoma control are implementing mass treatment programs in which azithromycin is used as part of the control strategy. Dose is determined by weight, which can be difficult to determine in field conditions. The purposes of this study were to determine whether an accurate dose could be determined by using height as a surrogate for weight and whether a single model of height-based dosage would be applicable in more than one setting.


METHODS
Data on height, weight, age, and gender of 5558 children aged 6 months to15 years were obtained from Kongwa and Rombo, Tanzania; Malakal, Sudan; Jareng, The Gambia; and Daboya, Ghana. Models for predicting weight by measuring height were developed that incorporated country-specific parameters. Doses of azithromycin assumed suspension of 40 mg/mL and 250-mg tablets that could be halved. Tolerance limits were defined as 15 to 30 mg/kg.


RESULTS
A regression model, predicting log weight as a function of log height, was the best fit and explained 94% of the variance. In children less than 1 year of age or 60 cm in height, dose determined by weight was preferred. Dosage by height resulted in more than 97% of children receiving doses within the tolerance limits. Children aged 1 to 2 years were the group most likely to be over- or undermedicated, but this occurred in only 6% of this age group.


CONCLUSIONS
Height-based determination of dosage of azithromycin in trachoma control programs appears to be feasible, using the height-based schedule proposed. One model was adequate for all the countries in the study. Further expansion to other countries is warranted.
Muñoz
Beatriz
B
Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
Solomon
Anthony W
AW
Zingeser
James
J
Barwick
Rachel
R
Burton
Matthew
M
Bailey
Robin
R
Mabey
David
D
Foster
Allen
A
West
Sheila K
SK
D000293:Adolescent; D000349:Africa / Q000453:epidemiology; D017677:Age Distribution; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017963:Azithromycin / Q000008:administration & dosage*; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D017678:Sex Distribution; D014141:Trachoma / Q000453:epidemiology / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D017963:Azithromycin