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Other Pediatric Literature of Interest


 

1. Uehara R, Yashiro M, Nakamura Y, Yanagawa H. Clinical features of patients with Kawasaki disease whose parents had the same disease. Arch Pediatr Adolesc Med. 2004;158:1166-9.

Authors from the Department of Public Heath, Jichi Medical School and Saitama Prefectural University in Japan note that in the 35 years that have passed since the initial descriptions of Kawasaki disease some patients who had the disease have reached reproductive age and, thus, familial cases of two generations occur. Based on responses to nationwide surveys of hospitals and pediatric departments 65 cases of Kawasaki disease were identified in children whose parents had the same diagnosis. The odds for having sibling cases of Kawasaki disease were significantly increased for patients whose parents had the disease (OR, 6.94; 95% CI, 2.77–17.38). Patients with parental Kawasaki disease were also more likely to have recurrent disease, receive additional intravenous immunoglobulin administrations, and to have coronary artery abnormalities. The authors aptly discuss significant limitations to the study design; however, they conclude that these results highlight the need for exploration of a possible genetic contribution to pathogenesis of Kawasaki disease.

2. Jacobs RF, Maples HD, Aranda JV, et al. Pharmacokinetics of intravenously administered azithromycin in pediatric patients. Pediatr Infect Dis J. 2005;24:34-9.

Azithromyin is an azalide antibiotic with in vitro activity against a spectrum of bacterial pathogens commonly treated in pediatric infections. Currently intravenous (IV) azithromycin is only approved for use in adults. These researchers from three sites of the Pediatric Pharmacology Research Unit Network report results of an open-label single-dose pharmacokinetic and tolerance study of intravenous azithromycin in a pediatric population. This information will be required to facilitate approval for use in the pediatric population, as well as guide dosing for therapeutic trials. The authors studied pharmacokinetics in 29 patients ages 0.5 to &lte;16 years of age and conclude that the disposition of IV administered azithromycin is comparable in patients in this age range; however, there was a tendency for increased clearance in younger children. The most common adverse effect was nausea that did not require intervention reported in 25% of the subjects.

3. Berger WE, Qaqundah PY, Blake, K, et al. Safety of budesonide inhalation suspension in infants aged six to twelve months with mild to moderate persistent asthma or recurrent wheeze. J Pediatr. 2005;146:91-5.

Current guidelines recommend inhaled corticosteroids (ICS) for long-term management of persistent asthma in children regardless of age. Currently the only nebulized ICS approved for use by the US Food and Drug Administration is budesonide. Controlled studies analyzing the safety and efficacy of budesonide exclusively in infants is lacking. Therefore, these researchers present a multicenter, randomized, double-blinded, parallel group, placebo-controlled study of 141 patients assessing the safety of once-daily administered nebulized budesonide in infants with persistent asthma. The primary outcome variable was adrenal function measured as mean changes from baseline to study end in postcosyntropin-stimulated plasma cortisol levels. The study was not powered to measure efficacy. The study concludes that the safety profile for nebulized budesonide was similar to that of placebo, with no suppression of adrenal function.

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