Update and clarification of ceftriaxone in the BNF for Children 2015-2016

Following feedback about the ceftriaxone monograph in BNFC 2015-2016 and online, we would like to provide an update and clarification:

In the current BNFC, the dosage and route of ceftriaxone remains unchanged from BNFC legacy. Although the routes for the dosing statement include intramuscular injection, this was never intended as a recommendation for child under 12 years with body-weight under 50kg, as doses of 50mg/kg and over were advised to be given by intravenous infusion only. Children over 50kg do have the option in this dosing statement to have ceftriaxone by intramuscular injection. However, since this information has been published, the SPC for Rocephin has been updated.

Over the last few months, we have been processing the updated SPC and we have also taken the opinion of expert advisers, the Paediatric Formulary Committee, and now are awaiting evidence from the manufacturer. This is to ensure the content we publish is clinically appropriate for paediatrics.

We appreciate the need to update the monograph based on the SPC as soon as possible, but we also want to ensure the dose and route are safe and appropriate before the monograph will be published.

Update for Valproic Acid in BNF and BNF for Children

The following sections in the Valproic acid monograph in BNF Publications will be updated for the next print edition/digital update to bring the content in line with the Sodium valproate monograph. The content will be updated in BNF 72 (September 2016) and BNF for Children 2016-2017. Digital versions will be updated at the next scheduled release date – April 2016.

The updated content will read as follows:

Contra-indications: Acute porphyrias p.864; personal or familial history of severe hepatic dysfunction; known or suspected mitochondrial disorders (higher rate of acute liver failure and liver-related deaths)

Breastfeeding: Present in milk – risk of haematological disorders in breast-fed newborns and infants

A downloadable version of this update can be found here:

Update to Valproic acid monograph