Population pharmacokinetics of fosmidomycin and clindamycin in combination with artesunate for uncomplicated Plasmodium falciparum malaria in Gabonese children and adults

We successfully developed robust population pharmacokinetic models for both fosmidomycin and clindamycin. These models confirmed that body weight is a key determinant of drug disposition for both agents, and that body temperature influences fosmidomycin clearance. While the current fosmidomycin dosing appears adequate across age groups, the standard 10 mg/kg dose of clindamycin results in lower exposure in young children compared to adolescence and adults. Dose simulation suggests that increasing clindamycin to 12 mg/kg in children under 35 kg would provide equal drug exposure in all age groups.