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Antimalarials in Children – Dosage Estimation

Ellen Mhango, Bergthora Snorradottir, Baxter Kachingwe, Kondwani Katundu, Sveinbjorn Gizurarson

Introduction: The current dosage of artemether – lumefantrine recommended by World Health Organization for treating malaria assumes that children are minor grown-ups. Nevertheless, children below five years of age are not small adults, as the enzymes responsible for metabolism have not attained maturity and the development of their physiology is incomplete etc.
Methods: In the current study, dosages for children below five years of age were calculated using different traditional approaches as well as using physiological and pharmacokinetic approaches.
Results: Depending on the approaches that were used to calculate the dosage, some children got underdosed while others were overdosed.
Conclusions: The results showed that children can be either undertreated or over treated which may lead to treatment failure or toxicity and ultimately death. This suggests that there is need to use an approach that incorporates developmental changes that happen at different stages of life to estimate the dose accurately. One such approach is the use of Physiological Based Pharmacokinetic Modelling. This approach may also be used for other drugs intended for use in the pediatric population.


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