Departments of Pediatrics.
Pharmacy, Seattle Children's Hospital, University of Washington.
J Pediatric Infect Dis Soc. 2017 Nov 24;6(4):399-402. doi: 10.1093/jpids/pix011.
Treatment options for adenovirus infection in immunocompromised children are limited. Nephrotoxicity has been associated with cidofovir use, but the rate of cidofovir-associated nephrotoxicity in pediatric patients is unclear. In a retrospective review of patients with adenovirus infection treated with cidofovir, neonates (n = 5) had higher viral loads and shorter times to renal insufficiency than older children (n = 24). Higher weekly doses of cidofovir were associated with greater increases in creatinine levels. Of 29 courses of cidofovir, 9 were complicated by acute kidney injury; in these children, mortality was high. Cidofovir dosing in children needs to be optimized, and other therapeutic alternatives should be developed.
免疫功能低下儿童的腺病毒感染治疗选择有限。西多福韦的使用与肾毒性相关，但儿科患者中与西多福韦相关的肾毒性发生率尚不清楚。在对接受西多福韦治疗的腺病毒感染患者进行的回顾性研究中，新生儿（n = 5）的病毒载量更高，肾功能不全的时间也比年龄较大的儿童（n = 24）更短。西多福韦的每周更高剂量与肌酐水平的更大升高相关。在 29 个西多福韦疗程中，有 9 个并发急性肾损伤；在这些儿童中，死亡率很高。需要优化儿童的西多福韦剂量，并且应该开发其他治疗替代方案。
