Fondaparinux for the Treatment of Superficial-Vein Thrombosis Superficial-vein thrombosis (SVT) of the legs is a condition more common that deep-vein thrombosis. Patients with SVT are at risk for subsequent symptomatic venous thromboembolic

VoriconazoleNPharmacokineticsNin Immunocompromized Children Voriconazole is increasingly used in pediatric patients, but only a few studies have reported on the pharmacokinetics in this population. Important pharmacokinetic differences exist between adults and children receiving voriconazole, primarily a higher elimination capacity in pediatric patients, likely due to their greater ratio of liver mass to body mass than seen in adults. An open-label, parallel-group study of the pharmacokinetics and safety was done in immunocompromized children aged 2 to less than 12 years and adults. Twelve children and 12 adults with hematological malignancies who required treatment for the prevention or therapy of systemic fungal infections were included in the study. Nine children received a voriconazole dose of 7 mg/kg intravenously every 12 hours over the entire study period. Twelve adults and three children received two loading doses of 6 mg/kg every 12 hours, followed by a maintenance dose of 5 mg/kg for the children or 4 mg/kg for the adults, both given every 12 hours. The children had mean age of 7 years and the adults averaged 44 years of age. The plasma trough levels of voriconazole in children receiving 7 mg/kg were not significantly different from the values obtained in adults receiving a dose of 4 mg/kg intravenously. The children had significantly higher C max values, but other pharmacokinetic parameters were not significantly different from those of adults. Voriconazole exhibited nonlinear pharmacokinetics in the majority of children. In children 2 to < 12 years old, the European Medicines Agency approved dose of 7 mg/kg every 12 hours of voriconazole intravenously provides exposure (area under the curve) comparable to that observed in adults with a dose of 4 mg/kg every 12 hours. Michael C, Bierbach U, Frenzel K, et al. Voriconazole pharmacokinetics and safety in immunocompromized children compared to adult patients. Antimicrob Agents Chemother 2010;54:3225-32.