Journal of Pediatric Pharmacology and Therapeutics最新文献

{"title":"Sulbactam-Durlobactam for Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Child: A Novel Application of Adult Pharmacokinetics.","authors":"Leah Rodriguez, Karla Resendiz, Bridget Blowey, Grace St Cyr, John McAteer","doi":"10.5863/JPPT-25-00096","DOIUrl":"https://doi.org/10.5863/JPPT-25-00096","url":null,"abstract":"<p><p>There are limited antimicrobial options for the treatment of carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAB). Sulbactam-durlobactam was recently approved for the treatment of CRAB in patients 18 years and older. However, CRAB infections can have mortality rates up to 80% in the intensive care unit. We describe the successful novel use of sulbactam-durlobactam in a pediatric patient using available adult pharmacokinetic data and preliminary pediatric dosing suggestions from a phase 1b trial.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 5","pages":"666-670"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185108","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":"Characterizing Cefepime Exposure in an Adolescent on Intermittent Hemodialysis Through Model-Informed Precision Dosing.","authors":"Shannon Reinert, Ronaldo Morales Junior, Emily Diseroad, Erin E Schuler, H Rhodes Hambrick, Sonya Tang Girdwood","doi":"10.5863/JPPT-25-00130","DOIUrl":"https://doi.org/10.5863/JPPT-25-00130","url":null,"abstract":"<p><p>There are no studies evaluating cefepime pharmacokinetics (PK) in pediatric patients receiving intermittent hemodialysis (iHD). Cefepime dosing in this population is particularly challenging owing to several variables that can affect clearance, including dialysis prescription, residual kidney function, fluid overload, and systemic inflammation. We describe cefepime PK parameters and concentration time profiles in an adolescent male undergoing iHD for whom a cefepime PK consult was requested. Using model-informed precision dosing, we were able to ensure the patient's current dosing of cefepime at 1000 mg daily maintained estimated free cefepime concentrations above 4 times the minimum inhibitory concentration (MIC) for MICs up to ∼4 mg/L while avoiding excessively high trough concentrations. Despite suspicion for increasing residual kidney function, due to increasing urine output, the patient's PK parameters were very similar 4 months later, when an additional consult was requested. This is the first published case describing cefepime PK in an adolescent on iHD and demonstrates the utility of model-informed precision dosing in this population.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 5","pages":"675-679"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184923","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":"3D Printing and Automated Compounding to Improve Pediatric Pharmacy Practice.","authors":"Sophia Tilley, Cynthia A Brasher, M Brooke Bernhardt","doi":"10.5863/JPPT-26-00021","DOIUrl":"https://doi.org/10.5863/JPPT-26-00021","url":null,"abstract":"","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 5","pages":"711-714"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184993","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":"Retrospective Safety Review of Undiluted IV Push Levetiracetam in Pediatric Patients.","authors":"Miah Thompson, Carol Vollmer-Johnson, Heather Townsend, Joseph Gassen","doi":"10.5863/JPPT-25-00093","DOIUrl":"https://doi.org/10.5863/JPPT-25-00093","url":null,"abstract":"<p><strong>Objective: </strong>Levetiracetam is traditionally given as an intravenous (IV) piggyback over a span of 15 minutes. Studies have shown administration of levetiracetam via IV push is safe and effective in adults; however, there are limited data within pediatrics. The objective of this study was to assess the safety and tolerability of IV push administration of undiluted levetiracetam in pediatric patients from neonates to 17 years of age.</p><p><strong>Methods: </strong>This was a single-center, retrospective observational study of pediatric patients who received at least 1 dose of undiluted IV push levetiracetam at a combined pediatric and adult community medical center. Patients were included if they were younger than 18 years and received an IV push dose of levetiracetam of 19 mg or greater. Patients were excluded if they received IV push lacosamide in addition to IV push levetiracetam. The primary outcome was treatment-associated adverse events within 1 hour of levetiracetam administration.</p><p><strong>Results: </strong>A total of 103 patients, with an associated 446 levetiracetam administrations, were identified for inclusion in this study. The mean age at the time of levetiracetam administration was 8 years (range, 1 day-17 years). There were 46 treatment-associated adverse events (10.3%) identified within the first hour after administration. The most common adverse events identified included increased blood pressure (85%), agitation (4%), drowsiness (4%), and hypotension (4%). The highest score obtained was 6 on the Naranjo Adverse Drug Reaction Scale, which is considered a probable reaction.</p><p><strong>Conclusions: </strong>Undiluted, IV push levetiracetam appears to be safe in pediatric patients from neonates to 17 years of age.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 5","pages":"617-621"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184938","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":"Characteristics of Youth With Type 2 Diabetes Prescribed Sodium-Glucose Cotransporter-2 Inhibitors Surrounding FDA Approval at an Academic Pediatric Medical Center.","authors":"Erika Y Choi, Presley Nichols, Andrew Jergel, Shuai Hao, Daniel S Hsia","doi":"10.5863/JPPT-25-00116","DOIUrl":"https://doi.org/10.5863/JPPT-25-00116","url":null,"abstract":"<p><strong>Objective: </strong>Sodium-glucose cotransporter-2 inhibitors (SGLT2i) were approved by the United States Food and Drug Administration (FDA) for the treatment of type 2 diabetes mellitus (T2DM) in children aged 10 years and older on June 20, 2023. We describe SGLT2i prescribing trends among all specialties at a quaternary care pediatric medical center surrounding the approval of empagliflozin, then identify characteristics of patients with T2DM associated with a higher likelihood of SGLT2i prescription by pediatric endocrinologists.</p><p><strong>Methods: </strong>We compared the total number of new SGLT2i prescriptions sent by all specialties before and after FDA approval of empagliflozin, between July 1, 2022, and June 30, 2024. We then identified children aged 10 years and older with T2DM who were newly prescribed an SGLT2i by pediatric endocrinologists. Demographic and clinical characteristics were compared with those of children with T2DM not prescribed SGLT2i.</p><p><strong>Results: </strong>The number of SGLT2i prescriptions sent by pediatric endocrinologists increased, and the top prescribing specialty shifted from Cardiology to Endocrinology. Increasing glycosylated hemoglobin (HbA1c) was associated with higher odds of SGLT2i prescription (OR 1.2 [95% CI, 1.1-1.3]; p < 0.001) regardless of empagliflozin approval status, low-density lipoprotein cholesterol, or urine microalbumin/creatinine ratio. Those prescribed SGLT2i before FDA approval were older, male, more frequently on insulin, and less frequently on metformin. These differences between groups were not seen post-approval.</p><p><strong>Conclusions: </strong>SGLT2is were more likely to be prescribed for youth with higher HBA1c by pediatric endocrinologists. The presence of risk factors for cardiovascular or renal disease was less important in the decision to prescribe SGLT2i, despite their reno- and cardioprotective effects in adults. Prospective and qualitative data would be useful in further understanding prescribing practices.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 5","pages":"628-637"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184942","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":"Combating Immunization Misinformation: What's New?","authors":"Jennifer E Girotto, Selena Warminski, J Hunter Fly, Jessica Forster, Amanda A Cavness, Tamara Oz, Abby McKinney, Kristin C Klein","doi":"10.5863/JPPT-26-00035","DOIUrl":"https://doi.org/10.5863/JPPT-26-00035","url":null,"abstract":"<p><p>Immunization misinformation is rampant, and it is essential that pharmacists remain able to interpret, explain, and recommend evidence-based immunization information to parents and other health care professionals. The Pediatric Pharmacy Association's Immunization Committee strives to provide summaries of important evidence regarding changes to immunizations and clarify confusing or new immunization issues. We intentionally did not include long-standing issues that have already been well addressed elsewhere, either by our committee previously or by other national organizations. In this article, we address the background of immunization approvals, why placebo-controlled trials are not usually optimal, how and why immunization recommendations vary between countries, why it is essential to continue to obtain high rates of immunizations among children, as well as the safety of immunizations containing aluminum and yeast.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 5","pages":"680-688"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184991","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":"Assessment of Evidence-Based Pharmacologic Therapy for Pediatric Patients With HbSS Disease at a Single Pediatric Institution.","authors":"Rachel Gustafson, Alexis Hamelink, Joshua Elder","doi":"10.5863/JPPT-25-00092","DOIUrl":"https://doi.org/10.5863/JPPT-25-00092","url":null,"abstract":"<p><strong>Objective: </strong>In the United States, approximately 100,000 people currently live with sickle cell disease. Despite the prominence of disease, there remains room for enhancing patient care. The use of hydroxyurea has improved patient outcomes, showing a decrease in vaso-occlusive crises, acute chest syndrome, the need for blood transfusions, and mortality. Other strides in management include antibiotic prophylaxis for younger patients, optimization of immunizations, and institution of novel agents.</p><p><strong>Methods: </strong>The purpose of this study was to evaluate pediatric patients with sickle cell disease at a single institution by assessing adherence to the prescribing practices of evidence-based pharmacologic therapy. The primary outcome was evaluation of prescribing practices of hydroxyurea or erythrocytapheresis, antibiotic prophylaxis, and immunizations. Secondary outcomes include the prescribing of novel therapies, the evaluation of hydroxyurea dosing, and the comparison of vaccination rates with a previous study completed at the same institution. Data collected include active therapy with hydroxyurea or erythrocytapheresis, supportive care with antibiotic prophylaxis for patients younger than 5 years, and vaccination adherence per current guideline recommendations.</p><p><strong>Results: </strong>A total of 104 patients were included. Of those reviewed, 79% were prescribed hydroxyurea, and 17% were receiving erythrocytapheresis. Supportive care results showed 100% of patients younger than 5 years were receiving appropriate antibiotic prophylaxis. On comparison with a previous institutional -analysis, those up-to-date on vaccinations were 66% vs 9.4% (p < 0.05).</p><p><strong>Conclusions: </strong>Results demonstrated high prescribing rates of therapy with either hydroxyurea or -erythrocytapheresis and antibiotic prophylaxis but highlighted the continued opportunity to improve -vaccination rates.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 5","pages":"622-627"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184925","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":"The Utility of Using FilmArray Meningitis-Encephalitis PCR Panel (MEP) in Children Admitted With Meningitis and Encephalitis: Is It a Useful Stewardship Tool?","authors":"Ban Al-Sayyed, Kelli Covington, Pamela Nicoski, Madeleine Heyn, Gabriella Hunter-McElroy, Shibangi Pal, Marina Feffer, Louise Lie, Jenin Mannaa","doi":"10.5863/JPPT-25-00120","DOIUrl":"https://doi.org/10.5863/JPPT-25-00120","url":null,"abstract":"<p><strong>Objective: </strong>FilmArray Meningitis-Encephalitis Polymerase Chain Reaction (PCR) Panel (MEP) allows for rapid detection or exclusion of pathogens causing meningitis and encephalitis (ME) in neonates and children. Studies showed its high sensitivity and specificity as a tool in diagnosing ME. We conducted a retrospective study in our institution to evaluate MEP usage in our pediatric population, assess the agreement between MEP and cerebrospinal fluid (CSF) culture, and measure the impact of MEP results on discontinuing empiric antimicrobials.</p><p><strong>Methods: </strong>We reviewed electronic records of patients aged 0 to 18 years admitted with possible ME from January 1, 2019, to April 30, 2023. We excluded patients with ventriculoperitoneal shunt infections, immunocompromised hosts, and patients who did not receive antibiotics.</p><p><strong>Results: </strong>We included 136 patients admitted with possible ME and treated with antibiotics. Of all patients, 6.6% had viral PCR detected (n = 9), 3.7% had bacterial PCR detected (n = 5), 89.7% had negative PCR (n = 122). There was high agreement between MEP and CSF culture results (Gwet agreement coefficient was 0.9915). The comparison of MEP vs CSF pleocytosis showed a low sensitivity (24%). Empiric vancomycin was started in 41% of patients who had no additional focus of infection on admission (n = 46/111) and was discontinued within 12 hours of MEP results in 46.6% of cases (n = 21/46). Acyclovir was combined with antibiotics empirically in 13.5% of cases only (n = 15/111).</p><p><strong>Conclusion: </strong>MEP is an important diagnostic stewardship tool. It is highly sensitive and specific in diagnosing ME in children. Agreement with CSF cultures is very high. Using CSF pleocytosis as an indication for MEP testing has a low yield.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 5","pages":"638-643"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185103","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":"Evaluation of Heart-Rate Response Following Atropine Administration During Bradycardic Events in Infants: Fixed Minimum Dose Versus Weight-Based Dose.","authors":"Elyse M Schwab-Daugherty, Jeremy J Daugherty, Erin Hohenstein, Pamela D Reiter","doi":"10.5863/JPPT-25-00084","DOIUrl":"10.5863/JPPT-25-00084","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to compare the change in heart rate (HR) in patients less than 5 kg who received either the fixed minimum dose of atropine (0.1 mg) or the weight-based dose of atropine (0.02 mg/kg).</p><p><strong>Methods: </strong>This was a retrospective, single organization, dual-site cohort study of infants less than 5 kg who received atropine in the setting of a bradycardic event from January 1, 2014 to December 31, 2024. Patients were excluded if they received atropine for any other indication. Age at the time of atropine administration, gender, race, weight, and department location within the hospital, mean arterial pressure, and other resuscitative medications were collected.</p><p><strong>Results: </strong>A total of 36 atropine doses (representing 33 unique patients) met study inclusion. Twenty-seven administration events (75%) were provided as a weight-based dose with no minimum while 9 administration events (25%) were provided as a minimum dose of 0.1 mg. The mean change in HR from time of atropine administration to 5 minutes after atropine was 53.9 ± 37.7 beats per minute for patients who received the weight-based dose of atropine compared with 50.4 ± 18.4 beats per minute for patients who received the minimum dose of atropine (p = 0.864).</p><p><strong>Conclusions: </strong>Heart rate response following intravenous atropine to infants less than 5 kg at either 0.02 mg/kg or a minimum dose of 0.1 mg did not statistically differ.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 4","pages":"529-534"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707778","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":"Pharmacology of Bacteriophage Therapy in Children: A Re-Emerging Paradigm in Antibacterial Therapy.","authors":"Jennifer Le, John S Bradley, Nanda Ramchandar","doi":"10.5863/JPPT-25-00151","DOIUrl":"10.5863/JPPT-25-00151","url":null,"abstract":"<p><p>The rise of antibiotic-resistant bacteria has reignited global interest in bacteriophages as potential therapeutic agents. Bacteriophage (phage) therapy provides an alternative to conventional antibiotics to treat serious infections caused by multidrug-resistant pathogens. In this narrative review, we explore the pharmacokinetics (PK), pharmacodynamics (PD), and clinical use of phage therapy in pediatric populations. We conducted PubMed searches for relevant publications from 1959 to September 2025. In contrast to most drugs, phages are self-replicating in the presence of target bacteria, necessitating the use of non-linear, dynamic pharmacology models to integrate phage-bacteria interaction (which can fluctuate over time, based on the presence of susceptible bacteria), as well as host factors such as immune clearance of phages and traditional host mechanisms of clearance of invasive bacterial pathogens. Phages are primarily cleared through the reticuloendothelial system, particularly in the liver and spleen. Advantages of phage therapy over antibiotics include a promising safety profile, preservation of the child's own microbiome, and, compared with some antibiotics, enhanced penetration into biofilms. Our knowledge of the benefits and risks of phage therapy is limited largely to current pediatric case reports and case series. The clinical use spans a wide breadth of clinical infections, mostly involving poorly responsive infections caused by multidrug-resistant bacteria. Until robust, prospective PK-PD and clinical trial data become available to guide therapy, phage therapy should be administered under protocols with individualized dosing and rigorous safety monitoring. Clinical applications using standardized, evidence-based dosing regimens and outcome assessments require further evaluation.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 4","pages":"483-492"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707907","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}