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Dosage individualization in children: integration of pharmacometrics in clinical practice
Wei Zhao, St¨¦phanie Leroux, Evelyne Jacqz-Aigrain
Paris, France
Author Affiliations: Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Shandong University, Jinan 250012, China (Zhao W); Department of Pediatric Pharmacology and Pharmacogenetics, Hôpital Robert Debr¨¦, APHP, Paris, France (Zhao W, Leroux S, Jacqz-Aigrain E); Clinical Investigation Center CIC1426, INSERM, Paris, France (Zhao W, Jacqz-Aigrain E); EA7323, Universit¨¦ Paris Diderot-Universit¨¦ Paris Descartes, Paris, France (Zhao W, Leroux S, Jacqz-Aigrain E); Division of Neonatology, Department of Child and Adolescent Medicine, CHU de Rennes, Rennes, France (Leroux S)
Corresponding Author: Wei Zhao, Pharm D, PhD, Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Shandong University, Jinan 250012, China; Department of Pediatric Pharmacology and Pharmacogenetics, Hôpital Robert Debr¨¦, 48 Boulevard S¨¦rurier, 75935 Paris Cedex 19, France (Tel: 0033 140033656; Fax: 0033 140035779; Email: wei.zhao@rdb.aphp.fr)
doi: 10.1007/s12519-014-0493-x
Background: Children are in a continuous and dynamically changing state of growth and development. A thorough understanding of developmental pharmacokinetics (PK) and pharmacodynamics (PD) is required to optimize drug therapy in children.
Data sources: Based on recent publications and the experience of our group, we present an outline on integrating pharmacometrics in pediatric clinical practice to develop evidence-based personalized pharmacotherapy.
Results: Antibiotics in septic neonates and immunosu-ppressants in pediatric transplant recipients are provided as proof-of-concept to demonstrate the utility of pharmacometrics in clinical practice. Dosage individualization based on developmental PK-PD model has potential benefits of improving the efficacy and safety of drug therapy in children.
Conclusion: The pharmacometric technique should be better developed and used in clinical practice to personalize drug therapy in children in order to decrease variability of drug exposure and associated risks of overdose or underdose.
World J Pediatr 2014;10(3):197-203
Key words: developmental pharmacokinetics;
developmental pharmacology;
pediatric pharmacology;
personalized therapy;
pharmacometrics;
quantitative pharmacology
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