Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
, 45 (1), 218-220

Paediatric Ganciclovir Dosing in Extracorporeal Membrane Oxygenation: Is Standard Dosing Good Enough?

Case Reports

Paediatric Ganciclovir Dosing in Extracorporeal Membrane Oxygenation: Is Standard Dosing Good Enough?

Mark Murphy et al. J Clin Pharm Ther.


What is known and objective: Ganciclovir is a first-line antiviral agent to treat cytomegalovirus disease in immunocomprimised patients. Ganciclovir pharmacokinetics in ECMO is unknown.

Case description: A 6-year-old with a stage IV extra-renal rhabdoid tumor with respiratory failure leading to extracorporeal membrane oxygenation had increasing serum CMV DNAemia while on ganciclovir.

What is new and conclusion: This is the first case report of ganciclovir pharmacokinetics in either paediatric or adult ECMO populations. Recommended dosing provided a low, subtherapeutic AUC24 with an associated increase CMV viral load. Higher doses of ganciclovir may be required in ECMO patients, especially without concurrent CRRT.

Keywords: clinical pharmacokinetics; clinical pharmacy; clinicians; pharmacists; pharmacodynamics; pharmacokinetics; therapeutic drug monitoring.

Similar articles

See all similar articles



    1. Nightingale SC. From the food and drug administration. JAMA. 1989;262(6):740.
    1. Wong DD, van Zuylen WJ, Craig ME, Rawlinson WD. Systematic review of ganciclovir pharmacodynamics during the prevention of cytomegalovirus infection in adult solid organ transplant recipients. Rev Med Virol. 2019;29(2):e2023.
    1. Luck S, Lovering A, Griffiths P, Sharland M. Ganciclovir treatment in children: evidence of subtherapeutic levels. Int J Antimicrob Agents. 2011;37(5):445-448.
    1. 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):301-305.
    1. Kim BJ, Jung JW, Shin YR, Park HK, Park YH, Shin HJ. Cytomegalovirus myocarditis required extracorporeal membrane oxygenation support followed by ganciclovir treatment in infant. Korean J Thorac Cardiovasc Surg. 2016;49(3):199-202.

Publication types

LinkOut - more resources