Polyethylene Glycol Dosing For Constipation In Children Younger Than 24 Months: A Systematic Review

Objectives:Evaluate safety and effectiveness of Polyethylene glycol (PEG) for chronic constipation in children aged younger than 24 months. Identify the optimum dose of PEG to manage chronic constipation in children aged younger than 24 months.Methods:In this systematic review, Embase, Medline Ovid, Pubmed, and the Cochrane Library were searched between January 1, 2000 and February 1, 2019. Studies investigating functional constipation, in which patients younger than 24 months of age were treated with PEG, were considered as potentially eligible for review. Two authors screened the studies against inclusion/exclusion criteria. Study quality was assessed with the PEDro quality assessment, Cochrane risk of bias tool, and/or the Newcastle-Ottawa Scale.Results:Five studies (2 randomized controlled trials, 3 retrospective chart reviews) satisfied selection criteria (n=459). All studies employed different dosage categories: mean effective maintenance dose, mean initial dose, mean short-term and long-term dose, and mean daily dose. Dosage regimens were variable, with 0.45 to 1.1g.kg(-1).day(-1) for PEG3350 and 0.48 to 0.65g.kg(-1).day(-1) for PEG4000. Adverse effects were transient across all studies for all types of PEG; these included diarrhea and abdominal pain.Conclusions:This systematic review provided evidence for a lack of reported side effects from PEG for children aged younger than 24 months. Evidence to establish appropriate dosage regimens does not exist.An infographic accompanying this article can be found at http://links.lww.com/MPG/B839.