tetano
Editor, Senior Moderator
Pharmacotherapy. 2019 Sep 12. doi: 10.1002/phar.2330. [Epub ahead of print]
[h=1]Peramivir for Influenza A and B Viral Infections: A Pharmacokinetic Case Series.[/h] Cies JJ[SUP]1,[/SUP][SUP]2,[/SUP][SUP]3[/SUP], Moore WS 2nd[SUP]1[/SUP], Enache A[SUP]4[/SUP], Chopra A[SUP]1,[/SUP][SUP]5,[/SUP][SUP]6[/SUP].
[h=3]Author information[/h] 1 The Center for Pediatric Pharmacotherapy LLC, Pottstown, PA, USA. 2 St. Christopher's Hospital for Children, Philadelphia, PA, USA. 3 Drexel University College of Medicine, Philadelphia, PA, USA. 4 Atlantic Diagnostic Laboratories, Bensalem, PA, USA. 5 NYU Langone Medical Center, New York, NY, USA. 6 NYU School of Medicine, New York, NY, USA.
[h=3]Abstract[/h] [h=4]OBJECTIVE:[/h] To describe the peramivir (PRV) pharmacokinetics in critically ill children treated for influenza A or B viral infections.
[h=4]DESIGN:[/h] Retrospective electronic medical record review of prospectively collected data from critically ill children receiving peramivir for influenza A or B viral infections in the pediatric intensive care unit (PICU).
[h=4]SETTING:[/h] A 189-bed, freestanding children's tertiary care teaching hospital in Philadelphia, PA.
[h=4]PATIENTS:[/h] Critically ill children admitted to the PICU who were infected with influenza between January 1, 2016 and March 31, 2018.
[h=4]INTERVENTIONS:[/h] None.
[h=4]RESULTS:[/h] Eleven patients, 2 females (18%) and 9 males (82%), accounted for 24 peramivir samples for therapeutic drug management. The median age was 5 years (interquartile range (IQR) 1.5 - 6.5 years) with a median weight of 16.4 kg (IQR 14 - 24 kg). Ten (91%) patients demonstrated a larger volume of distribution (V[SUB]d[/SUB] ), 11 (100%) patients demonstrated an increase in clearance (CL), and 11 (100%) patients demonstrated a shorter half-life estimate as compared with the package insert and previous pediatric trial data for peramivir. Eight (73%) patients tested positive for a strain of influenza A and 3 (27%) patients tested positive for influenza B; 4 of 11 (36%) patients tested positive for multiple viruses. All patients had adjustments made to their dosing interval to a more frequent interval. Ten (91%) patients were adjusted to an every 12 hour regimen and 1 (9%) patient was adjusted to an every 8 hour regimen. No adverse events were associated with peramivir treatment.
[h=4]CONCLUSION:[/h] The pharmacokinetics of PRV demonstrated in this PICU cohort differs in comparison to healthy pediatric and adult patients, and alterations to dosing regimens may be needed in PICU patients to achieve pharmacodynamic exposures. Additional investigations in the PICU population are needed to confirm these findings. This article is protected by copyright. All rights reserved.
? 2019 Pharmacotherapy Publications, Inc.
[h=4]KEYWORDS:[/h] influenza; pediatric; peramivir; pharmacodynamic; pharmacokinetics
PMID: 31514223 DOI: 10.1002/phar.2330
[h=1]Peramivir for Influenza A and B Viral Infections: A Pharmacokinetic Case Series.[/h] Cies JJ[SUP]1,[/SUP][SUP]2,[/SUP][SUP]3[/SUP], Moore WS 2nd[SUP]1[/SUP], Enache A[SUP]4[/SUP], Chopra A[SUP]1,[/SUP][SUP]5,[/SUP][SUP]6[/SUP].
[h=3]Author information[/h] 1 The Center for Pediatric Pharmacotherapy LLC, Pottstown, PA, USA. 2 St. Christopher's Hospital for Children, Philadelphia, PA, USA. 3 Drexel University College of Medicine, Philadelphia, PA, USA. 4 Atlantic Diagnostic Laboratories, Bensalem, PA, USA. 5 NYU Langone Medical Center, New York, NY, USA. 6 NYU School of Medicine, New York, NY, USA.
[h=3]Abstract[/h] [h=4]OBJECTIVE:[/h] To describe the peramivir (PRV) pharmacokinetics in critically ill children treated for influenza A or B viral infections.
[h=4]DESIGN:[/h] Retrospective electronic medical record review of prospectively collected data from critically ill children receiving peramivir for influenza A or B viral infections in the pediatric intensive care unit (PICU).
[h=4]SETTING:[/h] A 189-bed, freestanding children's tertiary care teaching hospital in Philadelphia, PA.
[h=4]PATIENTS:[/h] Critically ill children admitted to the PICU who were infected with influenza between January 1, 2016 and March 31, 2018.
[h=4]INTERVENTIONS:[/h] None.
[h=4]RESULTS:[/h] Eleven patients, 2 females (18%) and 9 males (82%), accounted for 24 peramivir samples for therapeutic drug management. The median age was 5 years (interquartile range (IQR) 1.5 - 6.5 years) with a median weight of 16.4 kg (IQR 14 - 24 kg). Ten (91%) patients demonstrated a larger volume of distribution (V[SUB]d[/SUB] ), 11 (100%) patients demonstrated an increase in clearance (CL), and 11 (100%) patients demonstrated a shorter half-life estimate as compared with the package insert and previous pediatric trial data for peramivir. Eight (73%) patients tested positive for a strain of influenza A and 3 (27%) patients tested positive for influenza B; 4 of 11 (36%) patients tested positive for multiple viruses. All patients had adjustments made to their dosing interval to a more frequent interval. Ten (91%) patients were adjusted to an every 12 hour regimen and 1 (9%) patient was adjusted to an every 8 hour regimen. No adverse events were associated with peramivir treatment.
[h=4]CONCLUSION:[/h] The pharmacokinetics of PRV demonstrated in this PICU cohort differs in comparison to healthy pediatric and adult patients, and alterations to dosing regimens may be needed in PICU patients to achieve pharmacodynamic exposures. Additional investigations in the PICU population are needed to confirm these findings. This article is protected by copyright. All rights reserved.
? 2019 Pharmacotherapy Publications, Inc.
[h=4]KEYWORDS:[/h] influenza; pediatric; peramivir; pharmacodynamic; pharmacokinetics
PMID: 31514223 DOI: 10.1002/phar.2330