ArticleBMJ (Clinical research ed.)2006
Underdosing of antiretrovirals in UK and Irish children with HIV as an example of problems in prescribing medicines to children, 1997-2005: cohort study.
Article in BMJ (Clinical research ed.), 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
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Who cites it
34 citing papers in PubMed, 101 citations in OpenAlex.
- The DIANA Study: Continued Access to Darunavir/Ritonavir (DRV/r) and Long-Term Safety Follow-Up in HIV-1-Infected Pediatric Patients Aged 3 to < 18 Years.Drug safety · 2021Trial
- Nevirapine Resistance in Previously Nevirapine-Unexposed HIV-1-Infected Kenyan Infants Initiating Early Antiretroviral Therapy.AIDS research and human retroviruses · 2015Trial
- Trial
- Adherence to antiretroviral therapy and acceptability of planned treatment interruptions in HIV-infected children.AIDS and behavior · 2013Trial
- Off-label use of combined antiretroviral therapy, analysis of data collected by the Italian Register for HIV-1 infection in paediatrics in a large cohort of children.BMC infectious diseases · 2022Observational
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- The case for viral load testing in adolescents in resource-limited settings.Journal of the International AIDS Society · 2017Review
- Clinical outcomes in children and adolescents initiating antiretroviral therapy in decentralized healthcare settings in Zimbabwe.Journal of the International AIDS Society · 2017Article
- Antifungal stewardship considerations for adults and pediatrics.Virulence · 2017Review
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- Development of HIV drug resistance and therapeutic failure in children and adolescents in rural Tanzania: an emerging public health concern.AIDS (London, England) · 2017Article
- Article
- Off-label use of rilpivirine in combination with emtricitabine and tenofovir in HIV-1-infected pediatric patients: A multicenter study.Medicine · 2016Observational
- A Case Series of Acquired Drug Resistance-Associated Mutations in Human Immunodeficiency Virus-Infected Children: An Emerging Public Health Concern in Rural Africa.Open forum infectious diseases · 2016Article
- Review
- Model-Based Once-Daily Darunavir/Ritonavir Dosing Recommendations in Pediatric HIV-1-Infected Patients Aged ≥3 to <12 Years.CPT: pharmacometrics & systems pharmacology · 2015Article
- Antiretroviral treatment failure, drug resistance, and subtype diversity in the only pediatric HIV clinic in Rhode Island.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2015Article
- Systemic antifungal prescribing in neonates and children: outcomes from the Antibiotic Resistance and Prescribing in European Children (ARPEC) Study.Antimicrobial agents and chemotherapy · 2015Article
- Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
objectiveTo measure the extent of underdosing of antiretroviral drugs in children.
designMulticentre cohort study.
settingClinical centres in hospitals in the United Kingdom and Ireland in the collaborative HIV paediatric study (CHIPS).
participants615 HIV infected children aged 2-12 years receiving antiretrovirals.
main outcome measuresDoses relative to weight and height compared with current recommended doses in 2004 European guidelines.
resultsThe CHIPS cohort of 934 children comprises 80% of diagnosed HIV infected children in the UK and Ireland between January 1997 and March 2005, of which 66% (615) aged 2-12 years were prescribed antiretrovirals. Actual doses standardised to weight or surface area varied widely across individual drugs, antiretroviral class, and calendar time, with children underdosed (prescribed less than 90% of current recommended doses) from 6-62% child time at risk. Three serious issues in prescribing antiretrovirals, which may also be relevant to paediatric prescribing in general, were identified. Firstly, dosing was inadequate before incorrect recommendations at licensing were later revised when important pharmacokinetic results emerged. Secondly, guidelines stating dosage alternatives (by weight/surface area) for the same drug led to different and inconsistent doses. And, thirdly, ongoing growth was not adjusted for.
conclusionsLargely inadvertently, HIV infected children in the United Kingdom and Ireland have been underdosed with antiretrovirals, highlighting problems applicable throughout paediatric prescribing.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.