Voriconazole Dosing in Children Younger Than 3 Years Undergoing Cancer Chemotherapy or Hematopoietic Stem Cell Transplantation

J Pediatric Infect Dis Soc. 2018 May 15;7(2):169-171. doi: 10.1093/jpids/pix022.

Abstract

There are limited pediatric population pharmacokinetic data for voriconazole dosing, particularly in younger children. In a cohort of 34 patients younger than 3 years receiving voriconazole, the majority (n = 23, 68%) had a low initial serum concentration <1 mg/L. Among 23 children <2 years old, 19 (83%) had an initial trough <1 mg/L. There was large intra- and interindividual variability in trough levels. Dosing also varied from 3.3 to 19.6 mg/kg per dose. Only 2 of 34 patients had a documented adverse drug reaction attributable to voriconazole. More data are needed to establish optimal dosing in very young children.

MeSH terms

  • Antifungal Agents / administration & dosage*
  • Antifungal Agents / adverse effects
  • Antifungal Agents / pharmacokinetics*
  • Antineoplastic Agents / therapeutic use*
  • Child, Preschool
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Immunocompromised Host*
  • Leukemia, Myeloid, Acute / drug therapy
  • Leukemia, Myeloid, Acute / immunology
  • Leukemia, Myeloid, Acute / therapy*
  • Male
  • Mycoses / prevention & control*
  • Myelodysplastic Syndromes / drug therapy
  • Myelodysplastic Syndromes / immunology
  • Myelodysplastic Syndromes / therapy*
  • Retrospective Studies
  • Voriconazole / administration & dosage*
  • Voriconazole / adverse effects
  • Voriconazole / pharmacokinetics*

Substances

  • Antifungal Agents
  • Antineoplastic Agents
  • Voriconazole