Practical dosing of praziquantel for schistosomiasis in preschool-aged children

Area of Science:

• Tropical Medicine
• Infectious Diseases
• Pediatric Pharmacology

Background:

• Schistosomiasis affects preschool-aged children, posing unique dosing challenges for praziquantel.
• Current praziquantel formulations require adaptation for accurate pediatric dosing.
• Available 600-mg tablets can be split into 150-mg or 300-mg increments.

Purpose of the Study:

• To determine accurate praziquantel dosing schemes for children aged 3-72 months.
• To evaluate the feasibility of using existing praziquantel tablet formulations for pediatric schistosomiasis treatment.
• To establish weight-based dosing guidelines for young children using scored praziquantel tablets.

Main Methods:

• Examined dosing schemes for children aged 3-72 months (4-25 kg).
• Utilized weight-for-age growth references from sub-Saharan Africa and Brazil (n=106,230).
• Calculated accurate dosing within the target range of 40-60 mg/kg.

Main Results:

• Tablets divisible into four 150-mg quarters achieve adequate dosing for children ≥5 kg.
• Tablets divisible into two 300-mg halves are suitable for children ≥10 kg.
• Specific dosing regimens (e.g., ½ tablet for 5-7 kg, ¾ tablet for 8-10 kg) ensure 100% of subjects receive correct dosage.

Conclusions:

• Formulations divisible into four parts are preferred for children <11 kg.
• From 11 kg body weight, 600-mg praziquantel tablets divisible into quarters or halves can be used.
• These methods enable accurate praziquantel administration for pediatric schistosomiasis treatment.