WHO generic tool for assessing paediatric ARV dosing

The tool is an excel-based spreadsheet that allows for manipulation of the intended delivered dose given for any product (ARV drugs in this case) for a range of weight bands and their corresponding estimated body surface area (BSA) to examine whether the intended dose is above or below the target dose recommended. It can be adapted for single, dual or triple combinations.

The generic tool, although not completed, can be used to assess existing or potential products and to work out dosing schedules for any particular single or combination product. The report of the WHO meeting on paediatric dosing [pdf, 1.2 Mb] contains some worked example spreadsheets.

Instructions to use the generic tool

The excel file for each product contains 3 major areas.

Sheet 1: This contains the main data, where the data on the actual active ingredients are completed and can be manipulated depending on proportion or strength of API for different FDC products.

Sheet 2: This contains the doses selected examined by weight band and calculates the dose delivered based on the amount of formulation (ml/caps/tablets) selected for each weight. The amount intended to be delivered can be manipulated.

The formula using estimation of the surface area (m²) for each weight generates a list of the maximum and minimum intended dose delivered and allows visualization of the dose delivered at the lowest weight/estimated surface area and the dose delivered at the top weight/SA dose or estimated surface area. Where this is over the target range it is shaded red, where it is below the target range it is shaded yellow.

Sheet 3: This provides a visual picture of how much each selected dose can be expected to deliver at compared to the recommended range for the target dose. This enables any over or under dosing to be easily visualized.

Sheet 4: Where included this provides a simple summary table of the recommended dose by weight.