pediatric-drug-dosing

name	pediatric-drug-dosing
description	Weight-based and body-surface-area-based drug dosing calculator for pediatric patients. Includes common pediatric medications with age-appropriate dosing ranges.

Pediatric Drug Dosing Calculator

Calculate weight-based and body-surface-area-based drug doses for pediatric patients with built-in safety checks, maximum dose enforcement, and age-appropriate validation. Medication errors are three times more common in children than adults, and this skill provides multiple safety layers to reduce dosing errors at the point of care.

Quick Install

npx skills add Open-Medica/open-medical-skills --skill pediatric-drug-dosing

What It Does

• Calculates mg/kg dose ranges for common pediatric medications with frequency and route recommendations
• Enforces absolute maximum single-dose and daily-dose caps to prevent dangerous overdoses, including 10-fold errors
• Validates patient age against medication restrictions (e.g., ibuprofen contraindicated under 6 months, ceftriaxone caution in neonates under 28 days)
• Computes body surface area using the Mosteller formula for BSA-based dosing when height is provided
• Screens for known contraindications and generates clinical alerts before prescribing
• Provides indication-specific dosing guidance, available formulations/concentrations, and practical administration tips

Clinical Use Cases

• Acute Otitis Media Dosing: A pediatrician prescribing amoxicillin for a 20 kg child with acute otitis media uses the tool to confirm the standard dose (25-45 mg/kg/day TID) versus high-dose regimen (80-90 mg/kg/day BID for resistant organisms), with the tool capping at maximum single dose and flagging available suspension concentrations
• Emergency Department Fever Management: An ED physician calculates acetaminophen and ibuprofen doses for a febrile 8 kg infant, with the tool automatically flagging that ibuprofen is not recommended under 6 months and providing the correct infant concentration (160 mg/5 mL suspension)
• Neonatal Meningitis Coverage: A hospitalist ordering ceftriaxone for an 8 kg infant with suspected serious bacterial infection receives the tool's dose calculation (50-100 mg/kg/day) along with a critical alert about the absolute contraindication in neonates under 28 days receiving calcium-containing IV solutions
• Weight-Based Antiemetic Dosing: A nurse practitioner uses the tool to verify ondansetron dosing for a child with gastroenteritis, receiving both the mg/kg calculation and the simplified weight-band dosing (8-15 kg = 2 mg, 15-30 kg = 4 mg, >30 kg = 8 mg)

Safety & Evidence

• Safety Classification: Caution -- All calculated doses MUST be independently verified by a licensed pharmacist or physician before administration. This tool is a clinical decision support aid and does not replace professional judgment or current drug reference resources
• Evidence Level: High -- Drug dosing data sourced from Taketomo CK, et al. Pediatric & Neonatal Dosage Handbook (Lexicomp, latest edition), with safety architecture informed by Kaushal R, et al. "Medication Errors and Adverse Drug Events in Pediatric Inpatients" (JAMA 2001;285(16):2114-2120)

Example Usage

Calculating amoxicillin dose for a 5-year-old:

Calculate amoxicillin dose for a 20 kg child, age 60 months

Returns: 500-900 mg per dose (25-45 mg/kg), frequency Q8H (standard) or Q12H (high dose), maximum single dose 500 mg, oral route, available as 250 mg/5 mL or 400 mg/5 mL suspension. Includes clinical notes on high-dose regimens for AOM with risk factors and duration guidance.

BSA calculation for chemotherapy dosing:

Calculate BSA for a child weighing 25 kg and 120 cm tall

Returns: BSA 0.9129 m2 using Mosteller formula: sqrt((height x weight) / 3600).

Technical Details

• Category: Pediatrics
• Author: Open Medical Skills Community
• License: MIT
• Version: 1.0.0
• Script Language: Python
• Specialties: Pediatrics, Pharmacy
• Medications Covered: Amoxicillin, amoxicillin-clavulanate, acetaminophen, ibuprofen, ceftriaxone, prednisolone, ondansetron, albuterol

References

• Taketomo CK, Hodding JH, Kraus DM. Pediatric & Neonatal Dosage Handbook. Lexicomp, Latest Edition.
• Kaushal R, et al. "Medication Errors and Adverse Drug Events in Pediatric Inpatients." JAMA. 2001;285(16):2114-2120.
• Mosteller RD. "Simplified Calculation of Body-Surface Area." N Engl J Med. 1987;317:1098.