Journal of Pediatric Pharmacology and Therapeutics最新文献

{"title":"Medication Barriers and Challenges Experienced/Perceived by Caregivers in Pediatric Medication Management: A Scoping Review.","authors":"Anmol Toor, Tapanga Brooks, Andrea W Tang","doi":"10.5863/JPPT-25-00055","DOIUrl":"https://doi.org/10.5863/JPPT-25-00055","url":null,"abstract":"<p><p>The objective of this scoping review was to identify the challenges and barriers non-professional caregivers such as parents, experience/perceive when managing the medications for pediatric patients with chronic disease states in an outpatient setting. Embase and Ovid Medline databases were searched for articles published from inception to May 18, 2024. The search was limited to English language articles. Studies conducted in countries with a developing or transitioning economy, or those based in an institutional setting were excluded. This review was conducted as per the Joanna Briggs Institute Manual for Evidence Synthesis scoping review methodology and adhered to the PRISMA-SCr 2020 Checklist. Evidence selection and data extraction was completed independently by 2 reviewers (AT and TB) and then combined. Medication barriers were identified, grouped and themed using thematic analysis. Eight articles were included in this review. After extraction, 20 medication barriers were identified and themed into the following categories: drug factors, drug burden/regimen, access to medications, caregiver factors, child factors, health care system challenges, and fear and stigma. Drug factor medication barriers were highly endorsed by non-professional caregivers (25% of total barriers), followed by caregiver factors (20% of total barriers). To increase the likelihood of pediatric medication administration success, research focused on improving these barriers should be identified, especially those related to drug formulation and caregiver medication knowledge and forgetfulness.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 2","pages":"184-195"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Administration of Intravenous Ferric Carboxymaltose in a Patient With Iron-Deficiency Anemia and Allergy to 2 Oral Iron Preparations.","authors":"Jordan Wallace, Adriana Trabal","doi":"10.5863/JPPT-26-00105","DOIUrl":"https://doi.org/10.5863/JPPT-26-00105","url":null,"abstract":"<p><p>Iron deficiency is a common occurrence in the pediatric population, often leading to the development of anemia. The first line of treatment is oral iron administration for the resolution of anemia and replenishment of iron stores. Although rare, patients may present with allergic reactions to iron, which can limit treatment modalities. We present the case of a 14-month-old boy who presented with iron-deficiency anemia and demonstrated allergy to 2 oral iron formulations. Our institution developed a treatment plan that includes adding premedications and slowly titrating of the infusion rate for the administration of intravenous iron. The patient successfully tolerated 2 infusions without developing allergic reactions and experienced resolution of his iron-deficiency anemia. When patients with iron-deficiency anemia are allergic to oral iron formulations, their treatment options are limited. There are a few reports of effective desensitizations with intravenous ferric carboxymaltose in pediatric patients. Our successful experience may help guide other institutions with similar patients.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 2","pages":"266-269"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of US Pediatric Pharmacists Incomes: A Gender Comparison Survey Study by the Pediatric Pharmacy Association, Practice-Based Research Network.","authors":"Ioana Popovici, Manuel J Carvajal, Tara Higgins, Emily C Benefield, Michelle Condren","doi":"10.5863/JPPT-25-00095","DOIUrl":"https://doi.org/10.5863/JPPT-25-00095","url":null,"abstract":"<p><strong>Objectives: </strong>While gender disparities in the US workforce have received substantial attention, income inequalities among subspecialty pharmacists remain understudied. This study aimed to develop a professional profile of pediatric pharmacists in the United States, construct and test gender-specific income-determination models, and identify and compare factors influencing income among male and female pediatric pharmacists.</p><p><strong>Methods: </strong>Data were collected via a national survey targeting pediatric pharmacists. The survey included human-capital, job-related, and demographic variables. Separate income-determination models were estimated between genders, using ordinary least-squares with logged annual income as the dependent variable. Key covariates included hours worked, years of experience, administrative role, salary negotiation history, and work location.</p><p><strong>Results: </strong>A total of 285 responses were analyzed from a 29.3% response rate. Women outnumbered men 3:1. The average annual income difference between male and female pharmacists was $10,294 (6.4%, not significant); however, regression estimates showed significant differences in annual income determinants by gender (p ≤ 0.05). Work input and experience positively influenced income for both genders, but job-related covariates were significant only for women. Working more hours and having more years of experience led to bigger pay increases for men than for women. Projected annual earnings based on model estimates revealed a statistically significant gender income gap of $10,745.</p><p><strong>Conclusions: </strong>The study highlights a nuanced gender disparity in income among pediatric pharmacists, with income determinants functioning differently across genders. Although the average gender pay gap was not statistically significant, regression-based projections suggest potential underlying inequities. These findings call for further research and institutional dialogue to address gender-based income disparities in specialized pharmacy fields.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 2","pages":"206-213"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacterial Resistance Associated With Inhaled Tobramycin for Prevention of Ventilator-Associated Tracheitis in Mechanically Ventilated Neonates and Children Without Cystic Fibrosis: An Observational Pilot Study.","authors":"Avery Parman, Maura Shrestha, Jamie L Miller, Misty M Oldham, Stephen Neely, Peter N Johnson","doi":"10.5863/JPPT-25-00068","DOIUrl":"https://doi.org/10.5863/JPPT-25-00068","url":null,"abstract":"","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 2","pages":"274-278"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Administration of Undiluted Famotidine IV Push at a Large Pediatric Academic Medical Center.","authors":"Alexandra Caballero, Alexander Wang, Ferras Bashqoy, Francis De Los Reyes, Joanna Tracy, Anasemon Saad","doi":"10.5863/JPPT-25-00036","DOIUrl":"https://doi.org/10.5863/JPPT-25-00036","url":null,"abstract":"<p><strong>Objective: </strong>Famotidine is a commonly used agent in pediatric intensive care units. There is no data regarding the safety of undiluted intravenous push (IVP) administration in pediatrics; however, there are historical concerns for hemodynamic instability in the adult population. This study assesses the safety of famotidine administered undiluted IVP for doses ≥ 5 mg in pediatric patients.</p><p><strong>Methods: </strong>We performed a retrospective, observational, medication use evaluation in pediatric patients (≤ 18 years) who received famotidine undiluted IVP from February to July 2022. Patients with arterial lines and continuous cardiac telemetry were included. Patients requiring extracorporeal membrane oxygenation, receiving famotidine doses < 5 mg, or who had a change in vasoactive medication doses within 1 hour prior to famotidine IVP administration were excluded. The primary outcome was the incidence of hypotension and bradycardia within 45 minutes of undiluted famotidine IVP administration.</p><p><strong>Results: </strong>A total of 59 patients were included. There were 8 patients (13.6%) with hypotension and 1 patient (1.7%) with bradycardia after famotidine administration in the full cohort. Of these 9 patients, 7 had hypotension and bradycardia at baseline. Two patients (3.4%) required adjustment of their vasoactive medication within 45 minutes after receiving famotidine, although these patients were also postoperative day zero from cardiac surgery. None of the patients required a fluid bolus for hypotension following famotidine administration. The percent change in hemodynamics from baseline were minimal across the various time intervals.</p><p><strong>Conclusion: </strong>Famotidine administered undiluted IVP produced no clinically significant hemodynamic -adverse effects in critically ill pediatric patients.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 2","pages":"214-218"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Study of Cefepime and Meropenem Therapeutic Drug Monitoring in Pediatric Patients on Extracorporeal Therapy.","authors":"Kaitlin M McFarland, Christina J Smith, Sai Karwande, Adam W Brothers","doi":"10.5863/JPPT-25-00050","DOIUrl":"https://doi.org/10.5863/JPPT-25-00050","url":null,"abstract":"<p><strong>Objective: </strong>Patients on extracorporeal therapy receiving medications have the potential for large pharmacokinetic shifts. Data supporting dose adjustments for antibiotics in pediatric patients on extracorporeal membrane oxygenation (ECMO) or continuous renal replacement therapy (CRRT) are limited. Institutional data reveal that cefepime and meropenem troughs are often outside of goal ranges for patients on extracorporeal therapies. The objective of this research was to elucidate potential patterns between clinical characteristics, extracorporeal modalities, and total serum trough concentrations of cefepime and meropenem.</p><p><strong>Methods: </strong>This retrospective chart review evaluated all patients during the study period with a cefepime or meropenem serum concentration obtained while on ECMO or CRRT. Clinical circumstances were reported, and descriptive statistics were performed on various subgroups to determine which subpopulations experienced more out-of-range drug trough concentrations.</p><p><strong>Results: </strong>Twenty-one cefepime serum trough concentrations were reviewed for 11 patients, with the mean and median concentrations exceeding the pre-defined goal range. Fifty percent of serum cefepime concentrations from 6 patients on ECMO were supratherapeutic, whereas 92.9% of serum cefepime concentrations from 7 patients on CRRT were supratherapeutic. Seven serum meropenem concentrations were reviewed for 5 patients, and the mean, median, and IQR of the serum troughs were all within goal range, regardless of extracorporeal therapy used. All cefepime and meropenem serum trough concentrations that were collected after a pause in CRRT of at least 1 hour within the previous 24 hours exceeded the goal ranges. One possible neurotoxic event was identified in a patient receiving cefepime and CRRT.</p><p><strong>Conclusions: </strong>Pharmacists and providers should ensure that pauses in CRRT are accounted for when dosing these antibiotics and should be aware that standard cefepime dosing for these patients often leads to elevated trough concentrations.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 2","pages":"243-250"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Albumin and Other Plasma Proteins in Pediatric Patients: What, When, and How Much They Influence Antimicrobial Pharmacology.","authors":"Jacopo Angelini, Francesco Russiani, Sara Ferin, Sarah Flammini, Carlo Tascini, Jason A Roberts, Massimo Baraldo, Simone Giuliano","doi":"10.5863/JPPT-25-01215","DOIUrl":"https://doi.org/10.5863/JPPT-25-01215","url":null,"abstract":"<p><p>Plasma proteins play a critical role in antimicrobial drug exposure, particularly in special populations where protein concentrations and binding capacity may be altered. This review summarizes current knowledge on age-related changes in plasma protein concentrations and protein-binding variability, with a specific focus on pediatric populations. This variability can lead to substantial alterations in the unbound fraction of many antimicrobials, especially those that are highly protein-bound. Understanding these pharmacokinetic changes is fundamental for safe and effective antimicrobial dosing in particular patients such as pediatric patients, who may require specific dose adjustments based on the various stages of their physiological development, from birth to adolescence. During this growth period, each developmental stage may represent a clinical setting with distinctive characteristics that clinicians must consider when choosing the drug and its dosage, because pharmacokinetic parameters may change within a shorter and more variable time frame than observed in adult patients. In this context therapeutic drug monitoring (TDM) represents a key strategy for optimizing drug dosing and achieving target therapeutic drug concentrations.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 2","pages":"292-301"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated Serum Concentrations of Lacosamide and Perampanel in a Pediatric Patient Following Coadministration of Clarithromycin for <i>Mycoplasma pneumoniae</i> Pneumonia.","authors":"Shotaro Meguro, Toru Imai, Wakako Ishii, Emiko Momoki, Tadayasu Kawaguchi, Kengo Matsuda, Shintaro Watanabe, Susumu Ootsuka","doi":"10.5863/JPPT-25-00087","DOIUrl":"https://doi.org/10.5863/JPPT-25-00087","url":null,"abstract":"<p><p>Lacosamide (LCM) and perampanel (PER) are antiepileptic drugs eliminated, in part, by cytochrome P450 (CYP) 3A4. However, clinical reports of their interactions are limited. Here, we report the case of a 12-year-old girl with a history of infantile epileptic spasms syndrome, treated with LCM, PER, valproic acid (VPA), and levetiracetam (LEV), who was diagnosed with <i>Mycoplasma pneumoniae</i> pneumonia and prescribed clarithromycin (CAM). Owing to impaired consciousness, serum drug concentrations were measured on multiple occasions during hospitalization. Markedly elevated serum concentrations of LCM (2.3 × baseline) and PER (4.4 × baseline) were observed after initiation of CAM. These concentrations were normalized after CAM was discontinued. Serum concentrations of LEV and VPA remained unchanged. According to the Drug Interaction Probability Scale, interaction was considered probable, with a total score of 5. Clarithromycin likely induced a pharmacokinetic interaction via CYP3A4 inhibition, leading to increased serum concentrations of LCM and PER. Although the concomitant use of CAM with these agents is not contraindicated, the findings of this case suggest caution is warranted. When macrolide therapy is necessary, alternative agents with weaker CYP3A4 inhibition, such as azithromycin, may be preferable.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 2","pages":"256-261"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating LLM Integration in Pharmacometrics Through a Software Development Perspective.","authors":"Kyle Barrett, Samuel P Callisto","doi":"10.5863/JPPT-25-01208","DOIUrl":"https://doi.org/10.5863/JPPT-25-01208","url":null,"abstract":"","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 2","pages":"279-283"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Dose Versus High-Dose Methylprednisolone and Impact on Duration of Noninvasive Bilevel Positive Airway Pressure in Pediatric Severe Asthma Exacerbations.","authors":"Alyssa Wallace, Sarah Belz, Jessica Lundeen, Elizabeth Elliott, Parisa Kaviany, Matthew Sharron, Boh Song","doi":"10.5863/JPPT-24-00119","DOIUrl":"https://doi.org/10.5863/JPPT-24-00119","url":null,"abstract":"<p><strong>Objective: </strong>Corticosteroids are frequently used in asthma exacerbation management; however, there are few data on optimal dosing for patients needing positive pressure ventilation. The purpose of this study is to investigate the relationship between steroid dosing and asthma outcomes, specifically as it relates to patients admitted to the pediatric intensive care unit (PICU) who require noninvasive bilevel positive airway pressure (NBPAP) ventilation.</p><p><strong>Methods: </strong>This retrospective study evaluated patients older than 2 years, admitted to the PICU and initiated on NBPAP for an asthma exacerbation during the study period. The methylprednisolone low-dose (0.5 mg/kg/dose with a maximum of 15 mg every 6 hours) and high-dose (1 mg/kg/dose with a maximum of 60 mg every 6 hours) strategies were used to determine the cohorts. The NBPAP duration and PICU and hospital length of stay were recorded.</p><p><strong>Results: </strong>A total of 197 patients were included in the study: 95 patients made up the low-dose cohort and 102 patients were in the high-dose cohort. The patients in the low-dose cohort had a median time on NBPAP of 25.2 hours compared with 25.5 hours in the high-dose cohort (p = 0.949). There was also no -difference in PICU and hospital length of stay as well as inpatient steroid duration.</p><p><strong>Conclusions: </strong>No difference was observed between low-dose and high-dose methylprednisolone on -duration of NBPAP in pediatric severe asthma exacerbations.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 2","pages":"226-232"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}