Published in:
01-06-2020 | Ribavirin | Viewpoint
Pharmaceutical care recommendations for antiviral treatments in children with coronavirus disease 2019
Published in: World Journal of Pediatrics | Issue 3/2020
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Up to now, no antiviral therapeutic regimens with exact efficacy are recommended to be used in children with coronavirus disease 2019 (COVID-19). Interim Guidance for Diagnosis and Treatment (the sixth edition) of COVID-19 [1] only provided potential antiviral treatments in adults. According to the current guidelines for management in adults and children and available resources in antiviral drugs, we herein discussed the pharmaceutical care of the five antiviral treatments (IFN-α, lopinavir/ritonavir, ribavirin, chloroquine diphosphate and arbidol) in children with COVID-19 (Table 1).
Table 1
Dosage regimen and precaution of antiviral drugs in children
|
Drugs
|
Age available
|
Dosage regimen of COVID-19 in children
|
Precaution/contraindication
|
|---|---|---|---|
|
IFN-α
|
Nebulization: using with caution in neonates and infants younger than 2 months
|
Nebulization: 200,000–400,000 IU/kg or 2–4 μg/kg in 2 mL sterile water, twice daily for 5–7 days
Spray: 1–2 sprays on each nostril and 8–10 sprays on the oropharynx, once every 1–2 h, 8–10 sprays/day for 5–7 days
|
Contraindication: CrCl < 50 mL/min; histories of mental illness, severe or unstable heart disease, or aplastic anemia
|
|
LPVr
|
China: OS ≥ 6 months, T ≥ 2 years
USA: OS ≥ 14 days, T ≥ 6 months
|
Body weight (kg)
7–15: 12 mg/3 mg/kg/time, twice daily for 1–2 weeks
15–40: 10 mg/2.5 mg/kg/time, twice daily for 1–2 weeks
> 40: 400 mg/100 mg/time, twice daily for 1–2 weeks
|
Contraindication: patients with severe hepatic insufficiency
Not be recommended: children with jaundice
|
|
Ribavirin
|
China: oral dosage forms ≥ 6 years
USA and Europe: oral dosage forms ≥ 3 years
|
Intravenous infusion at a dose of 10 mg/kg every time (maximum 500 mg every time), 2–3 times daily
|
Not be recommended: CrCl < 50 mL/min
Should be discontinued: SCr > 2 mg/dL
Warning: hemolytic anemia
|
|
CD
|
Using with caution
|
No recommendation
|
Acute poisoning is usually fatal with a dose of 50 mg/kg
|
|
Arbidol
|
≥ 2 years for influenza in Russia
|
No recommendation
|
Using with caution in patients with liver dysfunction
|