Optimal regimens of praziquantel for schistosomiasis in young children.

In children aged 1–4 years with intestinal schistosomiasis, praziquantel 80 mg/kg (split into two 40 mg/kg doses 3 h apart) predicts parasitological cure, with AUC 0–24 strongly linked to cure.

• Why it matters: Limited PK/PD evidence for preschool-aged children leaves uncertainty about safe, effective praziquantel dosing beyond the WHO 40 mg/kg single-dose recommendation.
• What they did: The study measured praziquantel plasma concentrations after 40 mg/kg or 80 mg/kg in 1–4-year-olds, pooled these with prior 3–8-year-old PK data, fit a population two-compartment model, and used regression plus Monte Carlo simulations to evaluate exposure–cure relationships and dosing adequacy.
• The result: Simulations showed comparable exposures across fixed-dose and weight-based regimens, and praziquantel 80 mg/kg achieved parasitological cure rates >85% but showed lower antigen clearance (69.5%), implying possible incomplete worm elimination.

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