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DC Field | Value | Language |
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dc.contributor.author | Lai, T. | - |
dc.contributor.author | Yeo, C. Y. | - |
dc.contributor.author | Rockliff, B. | - |
dc.contributor.author | Stokes, M. | - |
dc.contributor.author | Kim, Hannah Yejin | - |
dc.contributor.author | Marais, B. J. | - |
dc.contributor.author | McLachlan, A. J. | - |
dc.contributor.author | Alffenaar, Jan-Willem C. | - |
dc.date.accessioned | 2024-05-16T03:11:17Z | - |
dc.date.available | 2024-05-16T03:11:17Z | - |
dc.date.issued | 2024 | - |
dc.identifier.citation | Journal of Antimicrobial Chemotherapy 79(4):703-711, 2024 | - |
dc.identifier.uri | https://wslhd.intersearch.com.au/wslhdjspui/handle/1/9601 | - |
dc.description.abstract | INTRODUCTION: Therapeutic drug monitoring (TDM) is a tool that supports personalized dosing, but its role for liposomal amphotericin B (L-amb) is unclear. This systematic review assessed the evidence for L-amb TDM in children. OBJECTIVES: To evaluate the concentration-efficacy relationship, concentration-toxicity relationship and pharmacokinetic/pharmacodynamic (PK/PD) variability of L-amb in children. METHODS: We systematically reviewed PubMed and Embase databases following PRISMA guidelines. Eligible studies included L-amb PK/PD studies in children aged 0-18 years. Review articles, case series of <five patients, editorials and animal studies were excluded. Quality assessment was performed using the Critical Appraisal of Clinical Pharmacokinetics tool. The concentration-efficacy and concentration-toxicity relationships and PK/PD variability were analysed. RESULTS: In total, 4220 studies were screened; 6 were included, presenting data on 195 children. Invasive candidiasis and aspergillosis were the two most common infections treated with L-amb. Studies showed significant PK variability due to age (mean age ranged from 14 days to 17 years), body weight, non-linear PK and changes in the volume of distribution. Limited evidence supported a peak concentration/MIC (Cmax/MIC) of 25-50 for optimal efficacy and an AUC24 of >600 mg.h/L for nephrotoxicity. L-amb doses of 2.5-10 mg/kg/day were reported to achieve Cmax/MIC > 25 using an MIC of 1 mg/L. CONCLUSIONS: While significant PK variability was observed in children, evidence to support routine L-amb TDM was limited. Further studies on efficacy and toxicity benefits are required before routine TDM of L-amb can be recommended. Copyright The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. | - |
dc.subject | Animals | - |
dc.subject | Infant, Newborn | - |
dc.subject | Antifungal Agents | - |
dc.subject | Drug Monitoring | - |
dc.subject | Amphotericin B | - |
dc.subject | Candidiasis, Invasive | - |
dc.title | Therapeutic drug monitoring of liposomal amphotericin B in children. Are we there yet? A systematic review | - |
dc.type | Journal Article | - |
dc.identifier.doi | https://dx.doi.org/10.1093/jac/dkae003 | - |
dc.subject.keywords | Allied Health | - |
dc.identifier.journaltitle | Journal of Antimicrobial Chemotherapy | - |
dc.identifier.department | Pharmacy | - |
dc.contributor.wslhd | Kim, Hannah Yejin | - |
dc.contributor.wslhd | Alffenaar, Jan-Willem C. | - |
dc.type.studyortrial | Systematic Review | - |
dc.identifier.pmid | 38252921 | - |
dc.identifier.facility | Westmead | - |
Appears in Collections: | Westmead Hospital 2019 - 2024 |
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