The International Journal of Pediatric Pharmacy Innovations and Care (IJPPIC) is committed to providing timely access to quality research and clinical insights that contribute to the advancement of pediatric pharmacy. Each issue contains peer-reviewed articles that reflect ongoing developments, innovative practices, and emerging challenges in the field.
Featured Articles in the Latest Issue
- Volume 1 (Issue 2) JULY– DECEMBER 2025
Research Articles
Population Pharmacokinetic Modelling and Dose Optimisation of Vancomycin in Neonatal Intensive Care Unit Patients
Vol.1(2); Pages:1-7. Published on July-2025
Abstract
Developmental changes, organ immaturity, and rapid physiological changes make neonates in intensive care units (ICUs) have a large range of drug pharmacokinetics. The objective of this study was to build a population pharmacokinetic (PopPK) model of vancomycin in neonatal intensive care unit (NICU) and to minimize or maximize dose regimens to reach therapeutic trough concentrations. The NONMEM software was used to analyze data on 76 NICU patients and covariates including postnatal age, body weight, and serum creatinine were significantly found to affect clearance and volume of distribution. Bootstrap and visual predictive checks were used to get the final model validated. Simulations using a model suggested weight- and age-dependent dosing to exceed 85 percent target attainment in the therapeutic range between 10-20 mg/L. These findings speak in favour of personalized vancomycin dosing in neonatal groups and emphasize the significance of the PopPK tools in pediatric personalized dosing.
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Optimization of Dosing of Intravenous Immunoglobulin for Pediatric Kawasaki Disease: A Pharmacokinetic-Pharmacodynamic Study
Vol.1(2); Pages:8-19. Published on October-2025
Abstract
Kawasaki disease (KD) is the most common acquired heart disease in children and treatment with intravenous immunoglobulin (IVIG) has significantly lowered the occurrence of coronary complication. Nevertheless, the dosing strategies still give a problem, especially among heavier children who can be under-exposed. The investigation was a pharmacokinetic-pharmacodynamic (PK-PD) trial that consisted of 64 children with acute KD at two European study sites. Serial plasma samples allowed the population PK models to be built, tying the exposure to IVIG with clinical effects, such as those to the coronary arteries and CRP normalization. Nominal 2 g/kg dosing resulted in therapeutic plasma exposure purposes in 78 percent of patients, but simulated effects showed unfavorable exposure in heavier patient classes. Individualized dosing strategies augmented the achievement of targets The adverse events were not of serious nature. These data justify pharmacometric-based dosing to maximize IVIG treatment in KD and improve cardiovascular outcomes.
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Low-Dose Methotrexate Clinical Outcomes in Juvenile Idiopathic Arthritis as an Observational Cohort study with Multinational Data
Vol.1(2); Pages:20-31. Published on November-2025
Abstract
Methotrexate is the backbone disease-modifying antirheumatic drug (DMARD) in juvenile idiopathic arthritis (JIA), however, prospective observational evidence is scarce. This multinational cohort study assessed JIA children on low-dose methotrexate to a 24-month follow-up. The clinical response was measured using the American College of Rheumatology pediatric criteria, the growth outcome and safety measures. At 2 years, 63\% of patients had achieved 70\% response in the disease, whilst 21\% had clinical remission. Growth patterns were conserved as compared with the untreated historical cohorts. An increase in liver enzymes was observed in 8 percent of patients but was resolved by reduction of the dose; other side effects were mild in nature. Parental education interventions made treatment adherence to be more than 85%. These clinical observations validate the long-term effectiveness and tolerability of methotrexate and the importance of individualized dosing and monitoring in practice in pediatric rheumatology.
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Pediatric Formulation Development of Oral Voriconazole in Invasive aspergillosis: A Phase I Safety and Pharmacokinetics Study
Vol.1(2); Pages:32-42. Published on November-2025
Abstract
Voriconazole is the chief antifungal used against invasive aspergillosis, but its use in children is little by unpredictable pharmacokinetics and restricted formulations. This was a Phase I trial that examined the safety, pharmacokinetics and acceptability of a novel oral suspension in 28 children (2-12 years) with suspected or proven invasive aspergillosis. Patients were put on weight adjusted doses with the therapeutic drug monitoring. Pharmacokinetic characterization demonstrated an improvement in bioavailability and a decrease in interpatient variability relative to the current generations, improving drug exposure. There were no drugrelated severe toxicities; the most commonly reported mild toxicities were hepatotoxicity (14%) and visual disturbances (11%) that were reversible. Acceptability was good and palatability high and ease of administration in the younger children. These results suggest that pediatric-specific drug formulations can address the therapeutic shortcomings and yield enhanced antifungal conclusions in children vulnerable of acquiring invasive fungal infections.
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Systematic Review and Meta-Analysis of Pain Management in Pediatrics with the Use of Intranasal Analgesics in Emergencies
Vol.1(2); Pages:43-52. Published on December-2025
Abstract
The management of pain is one of the clinical priorities in treating children in the emergency rooms especially when performing procedures including fracture reduction, repair of a laceration and burn. The meta-analysis involved 24 research studies encompassing 1,482 children evaluating the efficacy and safety of intranasal analgesics which were of fentanyl, ketamine, and dexmedetomidine. Intranasal fentanyl had similar analgesic effects to those of intravenous morphine, whereas ketamine was effective as an agent of procedural sedation. Dexmedetomidine had the potential to provide pre-procedural anxiolysis, but bradycardia merited attention. The reported adverse events predominantly were low intensity and short-lasting with no cases of respiratory depression requiring any intervention. Administration through the nose is rapid, resource-efficient, and not invasive, which indicates that it should be implemented in the practice of pediatric emergency room procedures.
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