Pharmacokinetics and tolerance of zidovudine in preterm infants
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- 作者：Edmund V. Capparelli ; Mark Mirochnick ; Wayne M. Dankner ; Suzette Blanchard ; Lynne Mofenson ; George D. McSherry ; Hannah Gay ; Gregory Ciupak ; Betsy Smith ; James D. Connor
- 刊名：The Journal of Pediatrics
- 出版年：2003
- 出版时间：January 2003
- 年：2003
- 卷：142
- 期：1
- 页码：47-52
- 全文大小：215 K
文摘
Objective To determine zidovudine pharmacokinetics and tolerance in premature human human immunodeficiency virus-exposed infants. Study design Pediatric AIDS Clinical Trials Group Study 331 was a multicentered prospective, open-label study of the use of zidovudine in premature infants. Thirty-eight infants <35 weeks' gestational age (GA) were studied while receiving zidovudine 1.5 mg/kg every 12 hours until 2 weeks of age, then 2.0 mg/kg every 8 hours until 6 weeks of age. Population pharmacokinetics were evaluated at 1, 2, and 4 weeks' postnatal age; zidovudine doses were adjusted to maintain troughs <3 μM. Results Zidovudine clearance was lower than reported in term infants at similar postnatal ages. Nine premature infants required dose reduction because of high levels (7/19 <30 weeks' and 2/19 ≥30 weeks' GA). Postnatal age, GA, serum creatinine, and furosemide use independently predicted zidovudine clearance. Zidovudine was generally well tolerated in this high-risk population. Conclusions Zidovudine clearance is greatly reduced in premature infants. We recommend the following zidovudine dosing schedule in this population: 1.5 mg/kg (intravenous) or 2.0 mg/kg (oral) every 12 hours increased to every 8 hours at 2 weeks of age (≥30 weeks' GA) or at 4 weeks (<30 weeks' GA). (J Pediatr 2003;142:47-52)