{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T07:16:31Z","timestamp":1765610191756,"version":"3.37.3"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,8]],"date-time":"2021-11-08T00:00:00Z","timestamp":1636329600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,8]],"date-time":"2021-11-08T00:00:00Z","timestamp":1636329600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Ganciclovir pharmacokinetics is characterized by a high variability in drug exposure. Usually, monitoring of ganciclovir exposure is performed by measuring trough concentration. However, due to the specificity of pediatric pharmacokinetics, trough concentration measurements may not be a relevant surrogate of ganciclovir exposure. Area under the curve of concentration (AUC) may be a more appropriate biomarker.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We report the case of 3.6-year-old boy with Emberger syndrome with a cytomegalovirus reactivation occurring after allogenic hematopoietic stem cell transplantation. After a few days of treatment with intravenous ganciclovir, sub-therapeutic trough ganciclovir concentrations were measured (&lt;\u20090.5\u00a0\u00b5g\/mL) and viral load still increased. Ganciclovir dosage was increased by two-fold to deal with this treatment failure. Trough concentrations remained sub-therapeutic. The patient had hematologic disorder therefore it was decided to estimate ganciclovir AUC to assess more accurately drug exposure before any further dosage modification. AUC<jats:sub>0\u201312\u00a0h<\/jats:sub> was measured at 51\u00a0\u03bcg\u00a0h\/mL, which was within the therapeutic range (40\u201360\u00a0\u03bcg\u00a0h\/mL). Afterward, viral load decreased and became undetectable.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This case report highlights that monitoring ganciclovir exposure based on AUC should be performed to tailor drug dosage in order to improve treatment efficacy and safety in pediatric patients.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-021-06828-8","type":"journal-article","created":{"date-parts":[[2021,11,8]],"date-time":"2021-11-08T12:02:59Z","timestamp":1636372979000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The need for area under the curve measurements in the field of ganciclovir therapeutic drug monitoring in children: a case report"],"prefix":"10.1186","volume":"21","author":[{"given":"Xavier","family":"Duval","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Lemaitre","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Pertuisel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie","family":"Probert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginie","family":"Gandemer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie-Cl\u00e9mence","family":"Verdier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1030-1750","authenticated-orcid":false,"given":"Camille","family":"Tron","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,11,8]]},"reference":[{"issue":"4","key":"6828_CR1","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1097\/QCO.0000000000000174","volume":"28","author":"SB Vora","year":"2015","unstructured":"Vora SB, Englund JA. Cytomegalovirus in immunocompromised children. Curr Opin Infect Dis. 2015;28(4):323\u20139.","journal-title":"Curr Opin Infect Dis"},{"issue":"4","key":"6828_CR2","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1097\/INF.0b013e3182463a19","volume":"31","author":"E Launay","year":"2012","unstructured":"Launay E, Th\u00e9\u00f4ret Y, Litalien C, Duval M, Alvarez F, Lapeyraque A-L, et al. Pharmacokinetic profile of valganciclovir in pediatric transplant recipients. Pediatr Infect Dis J. 2012;31(4):405\u20137.","journal-title":"Pediatr Infect Dis J"},{"issue":"3","key":"6828_CR3","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1111\/j.1399-3046.2006.00669.x","volume":"11","author":"J Vethamuthu","year":"2007","unstructured":"Vethamuthu J, Feber J, Chretien A, Lampe D, Filler G. Unexpectedly high inter- and intrapatient variability of Ganciclovir levels in children. Pediatr Transplant. 2007;11(3):301\u20135.","journal-title":"Pediatr Transplant"},{"issue":"2","key":"6828_CR4","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1517\/17425255.2015.988139","volume":"11","author":"C Stockmann","year":"2015","unstructured":"Stockmann C, Roberts JK, Knackstedt ED, Spigarelli MG, Sherwin CM. Clinical pharmacokinetics and pharmacodynamics of ganciclovir and valganciclovir in children with cytomegalovirus infection. Expert Opin Drug Metab Toxicol. 2015;11(2):205\u201319.","journal-title":"Expert Opin Drug Metab Toxicol"},{"issue":"9","key":"6828_CR5","doi-asserted-by":"publisher","first-page":"2356","DOI":"10.1093\/jac\/dkab195","volume":"76","author":"A-G M\u00e4rtson","year":"2021","unstructured":"M\u00e4rtson A-G, Edwina AE, Burgerhof JGM, Berger SP, de Joode A, Damman K, et al. Ganciclovir therapeutic drug monitoring in transplant recipients. J Antimicrob Chemother. 2021;76(9):2356\u201363.","journal-title":"J Antimicrob Chemother"},{"issue":"3","key":"6828_CR6","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1016\/S0031-3955(16)36251-4","volume":"34","author":"GJ Schwartz","year":"1987","unstructured":"Schwartz GJ, Brion LP, Spitzer A. The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin N Am. 1987;34(3):571\u201390.","journal-title":"Pediatr Clin N Am"},{"issue":"9","key":"6828_CR7","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1007\/s00467-003-1226-x","volume":"18","author":"D Zhang","year":"2003","unstructured":"Zhang D, Lapeyraque A-L, Popon M, Loirat C, Jacqz-Aigrain E. Pharmacokinetics of ganciclovir in pediatric renal transplant recipients. Pediatr Nephrol. 2003;18(9):943\u20138.","journal-title":"Pediatr Nephrol"},{"issue":"3","key":"6828_CR8","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1128\/AAC.01855-18","volume":"63","author":"BM Ritchie","year":"2019","unstructured":"Ritchie BM, Barreto JN, Barreto EF, Crow SA, Dierkhising RA, Jannetto PJ, et al. Relationship of ganciclovir therapeutic drug monitoring with clinical efficacy and patient safety. Antimicrob Agents Chemother. 2019;63(3):10.","journal-title":"Antimicrob Agents Chemother"},{"issue":"9","key":"6828_CR9","doi-asserted-by":"publisher","first-page":"5602","DOI":"10.1128\/AAC.02953-14","volume":"58","author":"E Gim\u00e9nez","year":"2014","unstructured":"Gim\u00e9nez E, Solano C, Azanza JR, Amat P, Navarro D. Monitoring of trough plasma ganciclovir levels and peripheral blood cytomegalovirus (CMV)-specific CD8 + T cells to predict CMV DNAemia Clearance In Preemptively Treated Allogeneic Stem Cell Transplant Recipients. Antimicrob Agents Chemother. 2014;58(9):5602\u20135.","journal-title":"Antimicrob Agents Chemother"},{"issue":"3","key":"6828_CR10","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1002\/psp4.12363","volume":"8","author":"K Jorga","year":"2019","unstructured":"Jorga K, Reigner B, Chavanne C, Alvaro G, Frey N. Pediatric dosing of ganciclovir and valganciclovir: how model-based simulations can prevent underexposure and potential treatment failure. CPT Pharmacomet Syst Pharmacol. 2019;8(3):167\u201376.","journal-title":"CPT Pharmacomet Syst Pharmacol"},{"issue":"1","key":"6828_CR11","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1111\/petr.12179","volume":"18","author":"A \u00c5sberg","year":"2014","unstructured":"\u00c5sberg A, Bjerre A, Neely M. New algorithm for valganciclovir dosing in pediatric solid organ transplant recipients. Pediatr Transplant. 2014;18(1):103\u201311.","journal-title":"Pediatr Transplant"},{"key":"6828_CR12","doi-asserted-by":"crossref","unstructured":"Franck B, Autmizguine J, Marquet P, Ovetchkine P, Woillard J. Pharmacokinetics, pharmacodynamics and therapeutic drug monitoring of valganciclovir and ganciclovir in transplantation. Clin Pharmacol Ther. 2021;cpt.2431.","DOI":"10.1002\/cpt.2431"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06828-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-021-06828-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06828-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,8]],"date-time":"2021-11-08T12:06:22Z","timestamp":1636373182000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-021-06828-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,8]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["6828"],"URL":"https:\/\/doi.org\/10.1186\/s12879-021-06828-8","relation":{},"ISSN":["1471-2334"],"issn-type":[{"type":"electronic","value":"1471-2334"}],"subject":[],"published":{"date-parts":[[2021,11,8]]},"assertion":[{"value":"28 June 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The parents gave their written consent for their child\u2019s personal or clinical details along with any identifying images to be published in this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no known competing interests or personal relationships that could have appeared to influence the work reported in this paper.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1143"}}