{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T16:05:54Z","timestamp":1784822754928,"version":"3.55.0"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T00:00:00Z","timestamp":1705881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Australian Government (RTP) Scholarship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Therapeutic drug monitoring (TDM) is a tool that supports personalized dosing, but its role for liposomal amphotericin B (L-amb) is unclear. This systematic review assessed the evidence for L-amb TDM in children.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To evaluate the concentration\u2013efficacy relationship, concentration\u2013toxicity relationship and pharmacokinetic\/pharmacodynamic (PK\/PD) variability of L-amb in children.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We systematically reviewed PubMed and Embase databases following PRISMA guidelines. Eligible studies included L-amb PK\/PD studies in children aged 0\u201318\u2005years. Review articles, case series of &amp;lt;five patients, editorials and animal studies were excluded. Quality assessment was performed using the Critical Appraisal of Clinical Pharmacokinetics tool. The concentration\u2013efficacy and concentration\u2013toxicity relationships and PK\/PD variability were analysed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 4220 studies were screened; 6 were included, presenting data on 195 children. Invasive candidiasis and aspergillosis were the two most common infections treated with L-amb. Studies showed significant PK variability due to age (mean age ranged from 14\u2005days to 17\u2005years), body weight, non-linear PK and changes in the volume of distribution. Limited evidence supported a peak concentration\/MIC (Cmax\/MIC) of 25\u201350 for optimal efficacy and an AUC24 of &amp;gt;600\u2005mg\u00b7h\/L for nephrotoxicity. L-amb doses of 2.5\u201310\u2005mg\/kg\/day were reported to achieve Cmax\/MIC\u200a&amp;gt;\u200a25 using an MIC of 1\u2005mg\/L.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>While significant PK variability was observed in children, evidence to support routine L-amb TDM was limited. Further studies on efficacy and toxicity benefits are required before routine TDM of L-amb can be recommended.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkae003","type":"journal-article","created":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T21:34:58Z","timestamp":1705959298000},"page":"703-711","source":"Crossref","is-referenced-by-count":6,"title":["Therapeutic drug monitoring of liposomal amphotericin B in children. Are we there yet? A systematic review"],"prefix":"10.1093","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9761-0072","authenticated-orcid":false,"given":"Tony","family":"Lai","sequence":"first","affiliation":[{"name":"Pharmacy Department, The Children\u2019s Hospital at Westmead , Sydney, NSW , Australia"},{"name":"The University of Sydney Infectious Diseases Institute (Sydney ID) , Sydney, NSW , Australia"},{"name":"Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney , Sydney, NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin-Yen","family":"Yeo","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Concord Hospital , Sydney , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley","family":"Rockliff","sequence":"additional","affiliation":[{"name":"Pharmacy Department, The Children\u2019s Hospital at Westmead , Sydney, NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Stokes","sequence":"additional","affiliation":[{"name":"Pharmacy Department, The Children\u2019s Hospital at Westmead , Sydney, NSW , Australia"},{"name":"The University of Sydney Infectious Diseases Institute (Sydney ID) , Sydney, NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1808-5036","authenticated-orcid":false,"given":"Hannah Yejin","family":"Kim","sequence":"additional","affiliation":[{"name":"Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney , Sydney, NSW , Australia"},{"name":"Pharmacy Department, Westmead Hospital , Sydney , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben J","family":"Marais","sequence":"additional","affiliation":[{"name":"The University of Sydney Infectious Diseases Institute (Sydney ID) , Sydney, NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4674-0242","authenticated-orcid":false,"given":"Andrew J","family":"McLachlan","sequence":"additional","affiliation":[{"name":"Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney , Sydney, NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6703-0288","authenticated-orcid":false,"given":"Jan-Willem C","family":"Alffenaar","sequence":"additional","affiliation":[{"name":"The University of Sydney Infectious Diseases Institute (Sydney ID) , Sydney, NSW , Australia"},{"name":"Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney , Sydney, NSW , Australia"},{"name":"Pharmacy Department, Westmead Hospital , Sydney , 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