Journal of Pediatric Pharmacology and Therapeutics最新文献_第2页

A Retrospective Analysis of Micafungin Prophylaxis in Children Under 12 Years Undergoing Chemotherapy or Hematopoietic Stem Cell Transplantation. 对接受化疗或造血干细胞移植的 12 岁以下儿童使用米卡芬净预防的回顾性分析。

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-08-01 Epub Date: 2024-08-13 DOI: 10.5863/1551-6776-29.4.379

Breana K Goscicki, Shirley Q Yan, Sherry Mathew, Audrey Mauguen, Nina Cohen

{"title":"A Retrospective Analysis of Micafungin Prophylaxis in Children Under 12 Years Undergoing Chemotherapy or Hematopoietic Stem Cell Transplantation.","authors":"Breana K Goscicki, Shirley Q Yan, Sherry Mathew, Audrey Mauguen, Nina Cohen","doi":"10.5863/1551-6776-29.4.379","DOIUrl":"10.5863/1551-6776-29.4.379","url":null,"abstract":"Objectives: Literature is limited regarding ideal micafungin dosing in pediatric patients with hematologic malignancies receiving chemotherapy or hematopoietic stem cell transplantation. Micafungin is an intravenous echinocandin with activity against Candida and Aspergillus species and has a favorable safety profile compared with other antifungal classes. Our objective was to evaluate the breakthrough invasive fungal infection (IFI) rate in pediatric patients who received a prophylactic micafungin course at our institution.Methods: A single-center, retrospective study was conducted between January 1, 2011, and July 31, 2017, to determine the IFI rate in patients receiving micafungin prophylaxis. Patients with suspected IFI were evaluated for probable or proven infection based on European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group Consensus Group invasive fungal disease definitions. Statistical analyses were descriptive.Results: A total of 170 prophylactic micafungin courses from 129 unique patients ages <12 years at a median dose of 3 mg/kg daily were identified. The rate of probable or proven breakthrough IFIs was 2.4% as determined by clinical, radiologic, microbiologic, and histopathologic criteria.Conclusions: A low rate of breakthrough IFI was seen with micafungin prophylaxis that is consistent with prior published adult hematopoietic stem cell transplantation studies. Micafungin was well tolerated, with liver function test elevations being transient in most cases and thought to be related to alternative factors.","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983474","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}

引用次数: 0

Evaluation of Serum Acetaminophen Concentration Utility for Closure of Patent Ductus Arteriosus. 评估血清对乙酰氨基酚浓度对关闭动脉导管未闭的作用

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-08-01 Epub Date: 2024-08-13 DOI: 10.5863/1551-6776-29.4.404

Jennifer M Giulietti, Alexandra D Sharpe

{"title":"Evaluation of Serum Acetaminophen Concentration Utility for Closure of Patent Ductus Arteriosus.","authors":"Jennifer M Giulietti, Alexandra D Sharpe","doi":"10.5863/1551-6776-29.4.404","DOIUrl":"10.5863/1551-6776-29.4.404","url":null,"abstract":"Objective: Acetaminophen for patent ductus arteriosus (PDA) closure has gained popularity over the last decade; however, therapeutic drug monitoring for this indication remains uncertain. The exact timing and goal trough serum acetaminophen concentration ranges are not well defined. The purpose of our study is to evaluate the impact of therapeutic drug monitoring on both PDA closure rates and identify real-world risk of hepatotoxicity.Methods: Retrospective single-center chart review of neonates admitted to the neonatal intensive care unit (NICU) between April 2016 and August 2022 with at least 1 serum acetaminophen concentration to monitor for PDA closure. Acetaminophen was initiated at 15 mg/kg administered intravenously every 6 hours and a trough serum concentration was obtained prior to the sixth or seventh dose. PDA closure was confirmed radiographically with corresponding provider documentation. Associations of efficacy to closure were -analyzed using descriptive statistics.Results: Thirty-eight neonates were included in the analysis, of which 18 (47%) achieved PDA closure. First serum acetaminophen trough concentration was obtained before the seventh dose [IQR, 6-8] and ranged from undetectable (< 5 mg/L) to 30.8 mg/L. Subgroup analysis of first concentrations revealed therapeutic trough, defined as 10 to 20 mg/L, did not correlate to PDA closure (no closure median concentration = 14.7 [IQR, 13-15.6] vs closure median concentration = 15.4 [IQR, 11.4-18.5], p = 0.42), or duration of treatment. No neonate experienced acetaminophen-associated toxicity.Conclusions: PDA closure did not correlate to serum acetaminophen trough concentration. The regimen of 15 mg/kg every 6 hours appears safe as no neonate experienced acetaminophen toxicity or discontinued treatment early.","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983482","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}

引用次数: 0

Management of Pediatric Parenteral Fluids. 小儿肠外输液管理。

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-08-01 Epub Date: 2024-08-13 DOI: 10.5863/1551-6776-29.4.346

Rachel Meyers

引用次数: 0

Iron Pill-Induced Gastritis in a Pediatric Patient Taking Ferrous Sulfate Tablets. 一名服用硫酸亚铁片的儿童患者因铁丸引发胃炎。

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-08-01 Epub Date: 2024-08-13 DOI: 10.5863/1551-6776-29.4.425

Charles B Chen, Shreeya Chugh, Deepthi Rao

引用次数: 0

Efficacy and Safety of Allopurinol on Chronic Kidney Disease Progression: A Systematic Review and Meta-Analysis. 别嘌醇对慢性肾病进展的疗效和安全性：系统回顾与元分析》。

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-08-01 Epub Date: 2024-08-13 DOI: 10.5863/1551-6776-29.4.359

Fatemeh Ghane Sharbaf, Elham Bakhtiari, Toktam Faghihi, Farahnak Assadi

{"title":"Efficacy and Safety of Allopurinol on Chronic Kidney Disease Progression: A Systematic Review and Meta-Analysis.","authors":"Fatemeh Ghane Sharbaf, Elham Bakhtiari, Toktam Faghihi, Farahnak Assadi","doi":"10.5863/1551-6776-29.4.359","DOIUrl":"10.5863/1551-6776-29.4.359","url":null,"abstract":"Objective: Hyperuricemia is associated with the progression of chronic kidney disease (CKD). Whether urate-lowering treatment with allopurinol can delay disease progression remains controversial.Methods: Relevant databases were searched. Randomized clinical trials comparing the efficacy and -safety of allopurinol in patients with CKD were selected. The primary outcomes were changes in serum uric acid concentration and estimated glomerular filtration rate (eGFR). Random-effects modeling was used to -calculate the standard mean difference (SMD) with 95% CIs.Results: Four trials enrolling 698 participants were included. All were 2-arm parallel trials with a mean duration follow-up of 22.5 months. Congenital anomalies of the kidney and urinary tract were the most common cause of CKD in children, whereas diabetes was the leading cause of CKD in adults. Allopurinol significantly increased the eGFR compared with control groups (SMD, 2.04; 95% CI, 0.60-3.49; p = 0.005; I2 = 98.23%). Allopurinol led to a significant decrease in serum uric acid concentration compared with the control group (SMD, -5.16; 95% CI, -8.31 to -2.01; p = 0.001; I2 = 98.80%). No significant difference in adverse effects was identified between treatment and control groups.Conclusions: Allopurinol treatment in patients with CKD and hyperuricemia slows the decline in eGFR as compared with placebo, without risk of increased adverse effects.","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983480","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}

引用次数: 0

The Importance of Determining the Level of Bone Metabolism Markers and Vitamin D in the First Year of Life in the Kazakh Population. 确定哈萨克人出生后第一年骨代谢标志物和维生素 D 水平的重要性。

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-08-01 Epub Date: 2024-08-13 DOI: 10.5863/1551-6776-29.4.410

Akmaral Zhumalina, Balash Tusupkaliev, Anna Mania, Irina Kim, Mairamkul Zharlykasinova

{"title":"The Importance of Determining the Level of Bone Metabolism Markers and Vitamin D in the First Year of Life in the Kazakh Population.","authors":"Akmaral Zhumalina, Balash Tusupkaliev, Anna Mania, Irina Kim, Mairamkul Zharlykasinova","doi":"10.5863/1551-6776-29.4.410","DOIUrl":"10.5863/1551-6776-29.4.410","url":null,"abstract":"Objective: The research aimed to determine the importance of vitamin D and markers of bone metabolism in the overall assessment of bone mineralization during a child's first year of life.Methods: The 198 children were selected by screening all infants seen at our pediatric clinic over a 2-year period from 2020-2022 and including those who met the eligibility criteria of being aged 0 to 1 year, healthy with no chronic conditions, and not on vitamin D supplementation. Children were divided into 3 groups depending on the content of vitamin D in the blood serum: sufficient, insufficient, and deficient. The markers of bone tissue status included: markers of mineral metabolism (calcium, phosphorus, parathyroid hormone, calcitonin), a marker of bone formation (osteocalcin), resorption marker (deoxypyridinoline). Laboratory values were obtained at the time of study enrollment during the initial study visit. Labs were not repeated during the course of the study.Results: A quarter of the infants exhibited vitamin D deficiency at enrollment with serum 25OHD concentrations below 20 ng/mL, which showed a positive correlation with serum calcium and phosphorus -concentrations and a negative correlation with PTH, while osteocalcin and deoxypyridinoline concentrations remained consistent regardless of vitamin D status.Conclusions: The study's practical significance allows for the recommendation of using vitamin D -concentrations as a marker to detect bone formation and mineral metabolism disorders in children during their first year of life. By identifying and addressing these issues early on, the health care system aims to ensure better musculoskeletal health for children.","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983501","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}

引用次数: 0

Effectiveness and Safety of Dexmedetomidine in Neonates With Hypoxic Ischemic Encephalopathy Undergoing Therapeutic Hypothermia. 右美托咪定对缺氧缺血性脑病新生儿治疗性低温的有效性和安全性

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-06-01 Epub Date: 2024-06-10 DOI: 10.5863/1551-6776-29.3.232

Ceyda Acun, Mahmoud Ali, Wei Liu, Sreenivas Karnati, Kelsey Fink, Hany Aly

{"title":"Effectiveness and Safety of Dexmedetomidine in Neonates With Hypoxic Ischemic Encephalopathy Undergoing Therapeutic Hypothermia.","authors":"Ceyda Acun, Mahmoud Ali, Wei Liu, Sreenivas Karnati, Kelsey Fink, Hany Aly","doi":"10.5863/1551-6776-29.3.232","DOIUrl":"10.5863/1551-6776-29.3.232","url":null,"abstract":"Objective: The objective of this study was to evaluate and compare the effectiveness and safety of dexmedetomidine as monotherapy between neonates with mild hypoxic ischemic encephalopathy (HIE) and moderate to severe HIE treated with therapeutic hypothermia (TH).Methods: This retrospective study included neonates of gestational age ≥36 weeks with a diagnosis of HIE and undergoing TH between January 2014 and December 2021. Patients were included if they received at least 6 hours of continuous sedation with dexmedetomidine. Baseline characteristics, dose and duration of medication, adverse events, liver and kidney function tests, and hospital course were reviewed.Results: Of the 97 neonates included, 46 had mild, 42 had moderate, and 9 had severe HIE. Dexmedetomidine was initiated at a median 5 hours of life, and the median infusion duration was 77 (46-87) hours. Fifty-two (53.6%) required at least 1 breakthrough opioid or sedative during the first 24 hours of dexmedetomidine infusion. Overall, 40 patients (41.2%) had at least 1 bradycardia episode with heart rate <80 beats/min and 14 patients (14.4%) had heart rate <70 beats/min. Hypotension was experienced by 7 patients (7.2%). Fifty-two patients (53.6%) were intubated in the delivery room and 33/52 (63.5%) were extubated on day of life 1 during dexmedetomidine infusion.Conclusions: Dexmedetomidine as monotherapy was effective and safe sedation for infants with HIE undergoing hypothermia. The most common side effect of dexmedetomidine was bradycardia. -Dexmedetomidine may be considered as first and single agent for neonates with HIE undergoing TH.","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11163906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306970","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}

引用次数: 0

Impact of Extracorporeal Membrane Oxygenation Circuitry on Remdesivir. 体外膜氧合回路对雷米地韦的影响。

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-06-01 Epub Date: 2024-06-10 DOI: 10.5863/1551-6776-29.3.248

Jeffrey J Cies, Wayne S Moore, Jillian Deacon, Adela Enache, Arun Chopra

{"title":"Impact of Extracorporeal Membrane Oxygenation Circuitry on Remdesivir.","authors":"Jeffrey J Cies, Wayne S Moore, Jillian Deacon, Adela Enache, Arun Chopra","doi":"10.5863/1551-6776-29.3.248","DOIUrl":"10.5863/1551-6776-29.3.248","url":null,"abstract":"Objectives: This study aimed to determine the oxygenator impact on alterations of remdesivir (RDV) in a contemporary neonatal/pediatric (1/4-inch) and adolescent/adult (3/8-inch) extracorporeal membrane -oxygenation (ECMO) circuit including the Quadrox-i oxygenator.Methods: One-quarter-inch and a 3/8-inch, simulated closed-loop ECMO circuits were prepared with a Quadrox-i pediatric and Quadrox-i adult oxygenator and blood primed. Additionally, 1/4-inch and 3/8-inch circuits were also prepared without an oxygenator in series. A 1-time dose of RDV was administered into the circuits and serial preoxygenator and postoxygenator concentrations were obtained at 0 to 5 minutes, and 1-, 2-, 3-, 4-, 5-, 6-, 8-, 12-, and 24-hour time points. The RDV was also maintained in a glass vial and samples were taken from the vial at the same time periods for control purposes to assess for spontaneous drug degradation.Results: For the 1/4-inch circuits with an oxygenator, there was a 35% to 60% RDV loss during the study period. For the 1/4-inch circuits without an oxygenator, there was a 5% to 20% RDV loss during the study period. For the 3/8-inch circuit with and without an oxygenator, there was a 60% to 70% RDV loss during the study period.Conclusions: There was RDV loss within the circuit during the study period and the RDV loss was more pronounced with the larger 3/8-inch circuit when compared with the 1/4-inch circuit. The impact of the -oxygenator on RDV loss appears to be variable and possibly dependent on the size of the circuit and -oxygenator. These preliminary data suggest RDV dosing may need to be adjusted for concern of drug loss via the ECMO circuit. Additional single- and multiple-dose studies are needed to validate these findings.","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11163913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307035","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}

引用次数: 0

Association Between Antibiotic Duration and Recurrence of Urinary Tract Infection in the Neonatal Critical Care Unit. 新生儿重症监护病房抗生素使用时间与尿路感染复发之间的关系

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-06-01 Epub Date: 2024-06-10 DOI: 10.5863/1551-6776-29.3.316

Kimberly Van, Priyanka H Patel, Kristen Jones, Christopher Jackson, Najla Faddoul, Anoop Pulickal

{"title":"Association Between Antibiotic Duration and Recurrence of Urinary Tract Infection in the Neonatal Critical Care Unit.","authors":"Kimberly Van, Priyanka H Patel, Kristen Jones, Christopher Jackson, Najla Faddoul, Anoop Pulickal","doi":"10.5863/1551-6776-29.3.316","DOIUrl":"10.5863/1551-6776-29.3.316","url":null,"abstract":"Objectives: Urinary tract infection (UTI) is the most common bacterial infection in infants. Current practice guidelines suggest a treatment duration of 7 to 14 days. Suboptimal therapy may increase the risk for recurrent UTIs leading to renal scarring and possibly chronic kidney disease. The primary objective is to evaluate the duration of therapy for UTIs and its association with the incidence of recurrent UTIs in a neonatal intensive care unit (NICU). The secondary objectives are to identify the risk factors and the most common organisms for recurrent UTIs.Methods: Patients were identified via the diagnosis codes for UTIs and were included if admitted to the NICU and if they received antibiotics prior to hospital discharge. Patients were divided into 2 groups: antibiotic treatment for 7 days or fewer and antibiotic treatment for greater than 7 days.Results: Eighty-six infants were included in the study. Twenty-six patients received antibiotics for 7 days or fewer, and 60 for more than 7 days. In the study, the median birth weight was 977 g and the median gestational age was 27.6 weeks. There was no significant difference in the rate of recurrent UTIs between the 2 groups (p = 0.66). However, in the subgroup analysis, the incidence was higher for patients receiving antibiotic therapy for fewer than 7 days versus 7 days (p = 0.03).Conclusion: There was no difference in recurrence of UTI between treatment groups (≤7 days versus >7 days), and recurrence was seen in a higher percentage of patients with a urinary tract anomaly.","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11163897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306966","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}

引用次数: 0

Lead Exposure in Children: Failure to Protect the Most Vulnerable. 儿童铅暴露：未能保护最脆弱的群体。

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-06-01 Epub Date: 2024-06-10 DOI: 10.5863/1551-6776-29.3.212

Jennifer Sample

引用次数: 0