Educational paper: do we need neonatal clinical pharmacologists?

European Journal of Pediatrics
Karel AllegaertJohn N van den Anker

Abstract

Effective and safe drug administration in young infants should be based on integrated knowledge concerning the evolving physiological characteristics of the infant who will receive the drug and the pharmacokinetic and pharmacodynamic characteristics of a given drug. Consequently, clinical pharmacology in neonates is as dynamic and diverse as the neonates we are entitled to take care of. Even more than median estimates, covariates of variability within the population are of clinical relevance. We aim to illustrate the complexity and the need for neonatal clinical pharmacology based on the gap between current and likely best clinical practice for two commonly administered compounds (aminoglycosides for infection and ibuprofen for patent ductus arteriosus) and one new compound (bevacizumab, to treat threshold retinopathy of prematurity). Progression has been made to render pharmacokinetic studies child size, e.g., low volume samples, optimal study design, and population pharmacokinetics. Challenges to further improve clinical pharmacology in neonates include, when appropriate, the validation of off-patent drug dosing regimens and of infant-tailored formulations. Knowledge integration, i.e., the use of available data to improve cur...Continue Reading

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Citations

Feb 7, 2014·European Journal of Pediatrics·Alcidésio SouzaHelena Coelho
Nov 16, 2013·European Journal of Pediatrics·Jon Widding FjalstadClaus Klingenberg
Jan 8, 2013·European Journal of Pediatrics·Karel Allegaert
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May 12, 2015·Expert Opinion on Drug Metabolism & Toxicology·Janko SamardzicKarel Allegaert
Jun 26, 2014·Expert Opinion on Drug Metabolism & Toxicology·Karel Allegaert
Aug 28, 2015·European Journal of Pediatrics·Ainara CampinoElena Santesteban
Jan 23, 2016·BMC Pediatrics·Alcidésio Sales de SouzaHelena Lutéscia Luna Coelho
Jan 9, 2016·European Journal of Pediatrics·Karel Allegaert, Catherine Sherwin
May 28, 2014·British Journal of Clinical Pharmacology·Karel Allegaert, Johannes N van den Anker
May 14, 2014·BioMed Research International·Karel AllegaertStephanie Laër
May 12, 2015·International Journal of Pharmaceutics·Janko SamardzicMilica Bajcetic
Jan 10, 2017·Expert Review of Clinical Pharmacology·Aggeliki KontouEmmanuel Roilides
Feb 8, 2013·World Journal of Clinical Pediatrics·Karel Allegaert
Jan 25, 2014·Expert Review of Anti-infective Therapy·Alison KentPaul T Heath
Nov 24, 2016·Vestnik otorinolaringologii·E P Karpova, D V Kharina
Jul 17, 2018·European Journal of Clinical Pharmacology·Davide GrisafiFrancesco Scaglione

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