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Murakoso K, Minagawa R, Echizen H. Developmental changes of fluconazole clearance in neonates and infants in relation to ontogeny of glomerular filtration rate: literature review and data analysis. J Pharm Health Care Sci. 2018;4:5doi: 10.1186/s40780-018-0103-5.
Murakoso, K., Minagawa, R., & Echizen, H. (2018). Developmental changes of fluconazole clearance in neonates and infants in relation to ontogeny of glomerular filtration rate: literature review and data analysis. Journal of pharmaceutical health care and sciences, 45. https://doi.org/10.1186/s40780-018-0103-5
Murakoso, Kazutoshi, et al. "Developmental changes of fluconazole clearance in neonates and infants in relation to ontogeny of glomerular filtration rate: literature review and data analysis." Journal of pharmaceutical health care and sciences vol. 4 (2018): 5. doi: https://doi.org/10.1186/s40780-018-0103-5
Murakoso K, Minagawa R, Echizen H. Developmental changes of fluconazole clearance in neonates and infants in relation to ontogeny of glomerular filtration rate: literature review and data analysis. J Pharm Health Care Sci. 2018 Mar 20;4:5. doi: 10.1186/s40780-018-0103-5. eCollection 2018. PMID: 29568540; PMCID: PMC5859487.
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J Pharm Health Care Sci. 2018 Mar 20;4:5. doi: 10.1186/s40780-018-0103-5. eCollection 2018.

Developmental changes of fluconazole clearance in neonates and infants in relation to ontogeny of glomerular filtration rate: literature review and data analysis.

Journal of pharmaceutical health care and sciences

Kazutoshi Murakoso, Ryoichi Minagawa, Hirotoshi Echizen

Affiliations

  1. 1Department of Pharmacotherapy, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo 204-8588 Japan.
  2. 2Department of Hospital Pharmacy, Soka Municipal Hospital, 2-21-1 Soka, Saitama, 340-8560 Japan.

PMID: 29568540 PMCID: PMC5859487 DOI: 10.1186/s40780-018-0103-5

Abstract

BACKGROUND: Fluconazole is frequently prescribed for the treatment of systemic fungal infection in neonates and infants. At present, prediction of fluconazole doses according to developmental changes in fluconazole clearance is not being done in these patients. We aimed to formulate a developmental model of fluconazole clearance taking into account the ontogeny of renal function, since the drug is largely eliminated renally.

METHODS: We systematically retrieved the data of fluconazole pharmacokinetics and renal function in children and adults from databases (MEDLINE and Japan Medical Abstracts Society). Datasets were retrieved from individual children or groups from 9 studies comprising 55 neonates or infants at postmenstrual age (PMA) 27-58 weeks. Datasets were retrieved from 5 studies comprising 60 children and from 13 studies comprising 152 adults. Datasets of glomerular filtration rate (GFR) for individual pediatric subjects were retrieved from 4 studies comprising 187 neonates or infants.

RESULTS: Fluconazole clearance normalized to body surface area (BSA) (CL

CONCLUSIONS: The present study indicates that fluconazole doses for neonates and infants may be predicted from developmental change of systemic clearance, the ontogeny of which parallels the maturation of nephron function.

Keywords: Fluconazole; Glomerular filtration rate; Infants; Neonates; Ontogeny; Pharmacokinetics; Postmenstrual age

Conflict of interest statement

Because the present study was conducted by analyzing publicly available data, neither ethics approval nor consent to participate were applicable.Not applicable.All authors declare that they have no co

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