PedDrugDose Title - Small
 Feedback from PedDrugDose Users: goes beyond finding a dosage
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About PedDrugDose
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PedDrugDose is a Windows (95 & greater) application for helping the health care professional dose oral liquid pediatric medications.  While at first glance this may seem like a relatively straightforward task, there are a number of mistakes which are often made. Medication dosing errors are entirely too common and as medical care "evolves" in this country, we are forced to spend less and less time with our patients.  Since correctly calculating a dose takes time, shortcuts are often made, sometimes with devastating results.

There have been a number of studies documenting the unacceptable high incidence of outpatient pediatric dosing errors - I have included a few on the main page to highlight this problem.

While a medical student, and later as a resident, I was able to experience the scope of this problem firsthand. We were taught the correct way to dose pediatric medications, but most practitioners would still use some guesswork or approximations and the reason given was always the time it takes to do it correctly.  Very often this justification would be followed by something like "and I've been doing it for long enough to know..."  I performed my own informal review of prescriptions written during two years of my training by students, residents and attendings at the various facilities I rotated through.  This involved looking at the records or prescription copies and running the calculations.  What I found was a surprisingly high error rate of about 40% (including minor errors) which was slightly higher than the published dosing error rates which vary between 5% and 31%1,2.  As a medical student, seeing that it took me more time to calculate a pediatric prescription dose (and I'm good at math!), I asked residents and attendings what they did to speed this up and both freely admitted to relying on experience with the medications and being able to estimate a dose for a child of this or that size. A medical student has that luxury of time to go through the calculations, but the residents and attendings do not (though if you look here3, manually doing the calculations doesn't help enough!). It is not, however, a "luxury" - patient safety demands that estimations and guesswork are removed from the process. It was therefore both the time required and an unearned confidence in the prescriber's own ability to estimate which seemed to be the usual causes for the errors.

Firmly convinced that there had to be a better way, I searched around for a program which would calculate the doses of a variety of medications, give multiple dosing regimens, know the dosing ranges and other parameters but allow me to change them and be user friendly, as recommended by the ISMP in 1998.  I found no such program and so I decided to write my own.  PedDrugDose was first written in 2004 and was adopted by my residency program in 2005 just before I finished.  My partners and I use it daily where I currently practice, Skyline Family Practice, in Front Royal, VA.  I recently decided to turn this program into a commercial product, thus this web site.

My goal is to eliminate preventable pediatric medication dosing errors.  Please, if you have suggestions, feature requests, ideas for improvement, etc., do not hesitate to send them to me via email.

Steps Required
Steps Usually Taken
What You do with PedDrugDose
  • Pick a medication to use
  • Look up the concentrations available - choose one
  • Look up the dosing range (mg/kg/day)
  • Look up the dosing intervals - choose one
  • Convert the child's weight to kg if given in lbs
  • Calculate how many mg/day are required for this child (low and high)
  • Calculate the mg/dose using the dosing intervals
  • Calculate the ml/dose using your desired concentration
  • Round the ml/dose to a parent friendly figure (4 ml instead of 3.81, 1/2 tsp instead of 2.4ml, etc.
  • Now, check your work: convert your rounded ml/dose to mg/dose
  • Convert mg/dose to mg/day using your chosen dosing interval
  • Convert mg/day to mg/kg/day using the child's weight
  • Is it within the high and low range?  If not, something has to be changed (maybe tid works better than bid?) and the calculations re-run
  • Write prescription
  • Pick a medication to use
  • Remember the concentration you usually use or look one up
  • Remember the dosing range in mg/kg/day (or look it up)
  • Convert or estimate child's weight in kg
  • Convert mg/kg/day to mg/day
  • Convert mg/day to mg/dose
  • Convert mg/dose to ml/dose
  • Round ml/dose up or down based on approximately where in the dosing range you were (if at the high end, round down and vice versa)
  • Write prescription
  • Pick a medication to use from the alphabetical list or by using a full-text search
  • Select a concentration - the available ones are listed
  • Enter the child's weight in either lb or kg
  • The dosing ranges and dosing intervals are already entered but you may change them
  • Click "Calculate"
  • Choose a dosing regimen - all appropriate ones are listed for you with the back-calculations
  • Print Prescription

1. The epidemiology of prescribing errors: the potential impact of computerized prescriber order entry. Bobb A - Arch Intern Med - 12-APR-2004; 164(7): 785-92

2. Potential Medication Dosing Errors in Outpatient Pediatrics. McPhillips HA - J Pediatr - 01-DEC-2005; 147(6): 761-7

3. Assessing pediatrics residents' mathematical skills for prescribing medication: a need for improved training.  - Glover ML - Acad Med - 01-OCT-2002; 77(10): 1007-10

Home | Free Online Dosing | About PedDrugDose | What Does it Do?
Download | Purchase | Contact | About the Author