Aerosol therapy in children: challenges and solutions

Abstract

Using aerosolized medications for the treatment of children has gained importance over the years. However, aerosol drug delivery to infants and pediatrics is not an easy task as it has been influenced by many challenges. Most aerosol devices have been designed for use in adults not for children. Therefore, they require some critical assessment in device selection and often a level of adaptation for use with smaller children. It is well documented that each aerosol device and interface that have been used for the treatment of children has its own advantages and challenges in drug delivery. This paper provides a comprehensive review of dosing, drug-device combination, aerosol devices and interfaces used for drug delivery to children with pulmonary diseases. Solutions to the challenges with the aim of optimizing aerosol therapy in this patient population are also discussed.

Keywords::

• aerosol therapy
• aerosols
• drug delivery and children
• dry-powder inhalers
• metered-dose inhalers
• nebulizers

Financial & competing interests disclosure

J Fink serves as consultant to the biotech industry and is working or has worked with Aerogen, Aridis, Bayer, Boerhinger-Ingelheim, Dance, Jettstream, Parion, and WHO. The authors have no other relevant affiliation or financial involvement with any organization or entity with a financial conflict with the subject matter or materials discussed in the manuscript.

No writing assistance was utilized in the production of this manuscript.

Key issues

• • Aerosol drug delivery to children is complex.

• • There are several challenges with each device and interface that are used for aerosol drug delivery to children.

• • Information about the impact of these challenges on clinical outcomes is limited.

• • Poor understanding of solutions to these challenges leads to suboptimal aerosol drug delivery to children.

• • Limited information is available to guide clinicians in selection and use the best aerosol device and interface in the treatment of the individual child.