Bayesian model-guided antimicrobial therapy in pediatrics

Frontiers in Pharmacology

Pharmacology

Haden T. Bunn¹  Lindsey M. Floryance¹  Jogarao V. S. Gobburu² 

[1] Pumas-AI, Inc., Centreville, VA, United States;Pumas-AI, Inc., Centreville, VA, United States;School of Pharmacy, University of Maryland, Baltimore, MD, United States;

关键词: pediatrics;    antimicrobials;    bayesian;    precision dosing;    therapeutic drug monitoring;   

DOI  :  10.3389/fphar.2023.1118771

 received in 2022-12-07, accepted in 2023-06-12,  发布年份 2023

来源: Frontiers

【 摘 要 】

Antimicrobials have transformed the practice of medicine, making life-threatening infections treatable, but determining optimal dosing, particularly in pediatric patients, remains a challenge. The lack of pediatric data can largely be traced back to pharmaceutical companies, which, until recently, were not required to perform clinical testing in pediatrics. As a result, most antimicrobial use in pediatrics is off-label. In recent years, a concerted effort (e.g., Pediatric Research Equality Act) has been made to fill these knowledge gaps, but progress is slow and better strategies are needed. Model-based techniques have been used by pharmaceutical companies and regulatory agencies for decades to derive rational individualized dosing guidelines. Historically, these techniques have been unavailable in a clinical setting, but the advent of Bayesian-model-driven, integrated clinical decision support platforms has made model-informed precision dosing more accessible. Unfortunately, the rollout of these systems remains slow despite their increasingly well documented contributions to patient-centered care. The primary goals of this work are to 1) provide a succinct, easy-to-follow description of the challenges associated with designing and implementing dose-optimization strategies; and 2) provide supporting evidence that Bayesian-model informed precision dosing can meet those challenges. There are numerous stakeholders in a hospital setting, and our intention is for this work to serve as a starting point for clinicians who recognize that these techniques are the future of modern pharmacotherapy and wish to become champions of that movement.

【 授权许可】

Unknown   
Copyright © 2023 Bunn, Gobburu and Floryance.