Ganciclovir dosing in children

Check your answers on page 86https://doi.org/10.12968/jprp.2025.7.2.86

Ganciclovir is an intravenous antiviral medication used for preventing and treating viral infections caused by cytomegalovirus. In adults, the dosing can be a relatively straightforward 5 mg/kg (Neon Healthcare Ltd, 2023) – but in children the dosing needs adaptation to consider size (body surface area acting as a surrogate) and renal function, which makes the calculations slightly more involved. In addition to simply calculating the dose, the rates must also be considered as the concentration and will be affected by the dose.

The following case will consider prescribing and administration of an infusion of ganciclovir to a month-old term baby weighing 2.2 kg. The daily dose of prophylactic ganciclovir for a child of this age, in mg, is 3 x body surface area x eGFR (Neon Healthcare Ltd, 2023).

Calculate the body surface area (BSA) for this child, given that their length is 47 cm, using the Mostellar formula (Akkawi El Edelbi et al, 2023): BSA (m^2) = √((height (cm) × weight (kg)) / 3600)