Aerosol Therapy in Infants and Children: Special Considerations

Delivering drugs to infants and children can be a significant challenge. The devices currently available have been developed primarily for adults and have been modified or adapted for young children. As with patients of all age groups, drugs can have adverse side effects as well as therapeutic effects, and it is important to select devices and accessories that will maximize delivery to the lungs while minimizing extra-pulmonary deposition. Numerous factors influence pulmonary drug delivery such as characteristics of the aerosol delivery system, use of the device by the patient, variations in airways geometry, and disease of the upper and lower airways. In cooperative subjects, data suggests the within-subject coefficient of variation is similar to that seen in adults. Many of those dealing with patients are generally aware of the challenges of optimizing drug delivery at the different stages of development, although unfortunately this is far from universal. For those not dealing directly with patients, it is vital that the impact of developmental physical and mental issues are understood when considering the development of novel devices or the use of new chemical entities, if reliable delivery of drug to the lungs is to be
achieved.