Fondaparinux is a selective but indirect inhibitor of FXa by catalyzing antithrombin. It is approved for thromboprophylaxis in adults undergoing orthopedic surgery and abdominal surgery, and for treatment of adults with deep-vein thrombosis and pulmonary embolism (see Chapter 17). The agent does not cross-react with HIT antibodies. There are only two reports of fondaparinux use in children (Boshkov et al., 2004; Young and Nugent, 2004). In both cases, therapeutic levels could be achieved with a dose of 0.15 mg/kg given once daily. No adverse effects were noted during a period of several months. Clinical trials with fondaparinux are warranted before any further recommendations of its use in children can be made.

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