Major lacunae exist in our understanding of how developmental changes in
drug biotransformation influence drug’s exposure and thus its efficacy and toxicity in
children. It is not just about smaller weight in children, which modifies the pattern of
the drug's exposure. There are developmental, functional changes in organ systems,
liver to body mass ratios, and changes in metabolism. Understanding these changes
and conducting studies to obtain data on ontogeny of drug metabolizing enzymes is essential for implementation of
personalized dosing schedules in the pediatric population.