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Antimicrobial Agents and Chemotherapy, March 2001, p. 758-763, Vol. 45, No. 3
0066-4804/01/$04.00+0   DOI: 10.1128/AAC.45.3.758-763.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Determination of Dosing Guidelines for Stavudine (2',3'-Didehydro-3'-Deoxythymidine) in Children with Human Immunodeficiency Virus Infection

Sanjeev Kaul,1,* Mark W. Kline,2 Joseph A. Church,3 and Lisa M. Dunkle1,dagger

Bristol-Myers Squibb Pharmaceutical Research Institute, Princeton, New Jersey1; Texas Children's Hospital, Baylor College of Medicine, Houston, Texas2; and Childrens Hospital Los Angeles, University of Southern California, Los Angeles, California3

Received 22 September 2000/Returned for modification 23 January 2000/Accepted 29 November 2000

The results of the development of dosing guidelines for stavudine in human immunodeficiency virus (HIV)-infected children are summarized. Included in the integrated analyses were 21 and 33 HIV-infected pediatric and adult patients, respectively, from three phase I-II studies. Data for 21 children and 18 adults who received intravenous doses of 0.125 to 2 and 0.5 to 1 mg/kg of body weight, respectively, were used for the determination of dosing guidelines; exposure data for 16 children and 15 adults who received oral doses of 1 to 2 and 0.5 to 1 mg/kg/day, respectively, were used to validate the dosing recommendations for children. Significant relationships were observed between total body clearance (in milliliters per minute) in children and adults combined and demographic parameters of age, body weight, and body surface area (R2 = 0.77 to 0.80; P = 0.0001). Models of approximated pediatric dose based on clearance values and direct adult exposure yielded a stavudine dosage of 2 mg/kg/day for children of <= 30 kg of body weight and 1 mg/kg/day (adult dose) for children of >30 kg of body weight.


* Corresponding author. Mailing address: Bristol-Myers Squibb Pharmaceutical Research Institute, P.O. Box 4000, Princeton, NJ 08543-4000. Phone: (609) 252-5124. Fax: (609) 252-7035. E-mail: sanjeev.kaul{at}bms.com.

dagger Present address: Achillion Pharmaceuticals, New Haven, CT 06511.


Antimicrobial Agents and Chemotherapy, March 2001, p. 758-763, Vol. 45, No. 3
0066-4804/01/$04.00+0   DOI: 10.1128/AAC.45.3.758-763.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.