Historically, 75% of drugs have insufficient labeling to inform physicians on pediatric dosing, safety, or efficacy. Mechanisms requiring the study of new products in children are relatively new and highlight a training gap in pediatricians related t the investigation of therapeutic agents: There is an urgent need for well-trained pediatric investigators with quantitative research skills in pharmacology, epidemiology, and biostatistics. In this competitive renewal, the investigator, Daniel K. Benjamin, Jr., MD, PhD, MPH, will continue to prepare pediatricians for a career in patient-oriented research to help bridge this gap in accordance with his own long-term research goals: to improve pediatric drug development by establishing proper dosing, safety, and efficacy of drugs used in adolescents, children, toddlers, infants, and neonates. Dr. Benjamin successfully achieved the aims outlined in the original award by developing a research program in pediatric clinical pharmacology and therapeutics. The centerpiece of the program is the NICHD- sponsored Pediatric Trials Network (PTN) for which the applicant is PI and chair. The network has 27 active clinical trials and pharmacoepidemiology projects evaluating the pharmacokinetics, safety, and efficacy of 38 therapeutics. The breadth of the program is possible because the candidate successfully developed three young investigators who have secured their own NIH funding and their own mentees. In addition to offering research opportunities for the duration of the application, strengths of Dr. Benjamin's program include the unparalleled research infrastructure of the world's largest academic research organization, Duke Clinical Research Institute, and a longstanding academic partnership with the renowned University of North Carolina School of Pharmacy. Through this integral partnership, Dr. Benjamin has developed an NIH-sponsored fellowship training program and a pathway for pediatricians to secure PhD- level training in clinical pharmacology and pharmacoepidemiology. In this competitive renewal, the applicant seeks to continue using the PTN as a platform for mentorship of young investigators from both within and outside Duke University. Trainees in clinical pharmacology across the US will be recruited to lead network research projects. Specifically, the proposed "Antimicrobial Cerebrospinal Fluid Pharmacokinetics in High-Risk Infants" PTN study will offer mentees the opportunity to capitilize on the research program that Dr. Benjamin has developed. Feasibility of the proposed program expansion to national prominence and multi-institutional collaborative mentorship is shown by funding and career development of current trainees at Duke and UNC, by trainees'publication track record (over 90 peer-reviewed articles with trainees as first author, and by the initial mentorship of young investigators from other institutions including Children's Mercy Hospital, University of Louisville, and University California-San Diego.

Public Health Relevance

The applicant has built a successful program in pediatric clinical pharmacology and therapeutics, and seeks to expand upon that success through the mentorship of Duke University trainees and junior investigators from throughout the United States using the Pediatric Trials Network as a national resource to conduct high-quality, patient-oriented research.

National Institute of Health (NIH)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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Developmental Biology Subcommittee (CHHD)
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Higgins, Rosemary
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Duke University
Other Clinical Sciences
Schools of Medicine
United States
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Autmizguine, Julie; Hornik, Christoph P; Benjamin Jr, Daniel K et al. (2015) Anaerobic antimicrobial therapy after necrotizing enterocolitis in VLBW infants. Pediatrics 135:e117-25
Bain, J; Benjamin Jr, D K; Hornik, C P et al. (2014) Risk of necrotizing enterocolitis in very-low-birth-weight infants with isolated atrial and ventricular septal defects. J Perinatol 34:319-21
Tremoulet, Adriana; Le, Jennifer; Poindexter, Brenda et al. (2014) Characterization of the population pharmacokinetics of ampicillin in neonates using an opportunistic study design. Antimicrob Agents Chemother 58:3013-20
Camelo Castillo, Wendy; Boggess, Kim; Stürmer, Til et al. (2014) Trends in glyburide compared with insulin use for gestational diabetes treatment in the United States, 2000-2011. Obstet Gynecol 123:1177-84
Greenberg, Rachel G; Benjamin Jr, Daniel K (2014) Neonatal candidiasis: diagnosis, prevention, and treatment. J Infect 69 Suppl 1:S19-22
Tunks, Robert D; Barker, Piers C A; Benjamin Jr, Daniel K et al. (2014) Sildenafil exposure and hemodynamic effect after Fontan surgery. Pediatr Crit Care Med 15:28-34
Aliaga, Sofia; Clark, Reese H; Laughon, Matthew et al. (2014) Changes in the incidence of candidiasis in neonatal intensive care units. Pediatrics 133:236-42
Autmizguine, Julie; Moran, Cassie; Gonzalez, Daniel et al. (2014) Vancomycin cerebrospinal fluid pharmacokinetics in children with cerebral ventricular shunt infections. Pediatr Infect Dis J 33:e270-2
Ericson, Jessica E; Benjamin Jr, Daniel K (2014) Fluconazole prophylaxis for prevention of invasive candidiasis in infants. Curr Opin Pediatr 26:151-6
Gonzalez, Daniel; Paul, Ian M; Benjamin Jr, Daniel K et al. (2014) Advances in pediatric pharmacology, therapeutics, and toxicology. Adv Pediatr 61:7-31

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