期刊
ARCHIVES OF DISEASE IN CHILDHOOD
卷 107, 期 4, 页码 317-322出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/archdischild-2021-321831
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资金
- European Union as part of The Global Research in Paediatrics (GRiP) network [261 060]
The study found that enteral formulations in the WHO Essential Medicine List for children were more age-appropriate for older children (6-11 years old) than for younger children. Only a small proportion of formulations were considered age-appropriate for children under 6 years old. However, medications for targeted diseases like HIV and tuberculosis were mostly age-appropriate in the list.
Introduction The WHO Essential Medicine List for children (EMLc) is used for promoting access to medicines.The age-appropriateness of enteral (oral and rectal) formulations for children depend on their adaptability/flexibility to allow age-related or weight-related doses to be administered/prescribed and the child's ability to swallow, as appropriate. There is scant information on the age-appropriateness of essential enteral medicines for children. Objective To evaluate the age-appropriateness of enteral essential medicines. Materials and methods Age-appropriateness of all enteral formulations indicated and recommended in the EMLc 3rd to 7th (2011-2019) editions were determined by assessing swallowability and/or dose adaptability for children under 12 years, stratified into five age groups. Results Enteral formulations in the EMLc were more age-appropriate for older children aged 6-11 years than for younger children. In the 3rd edition, for older children, 77%, n=342, of formulations were age-appropriate. For younger children, age-appropriateness decreased with age group: 34% in those aged 3-5 years, 30% in those aged 1-2 years, 22% among those aged 28 days to 11 months and 15% in those aged 0-27 days. Overall, similar proportions were found for the 7th edition. In contrast, the majority of medicines in the 7th list were age-appropriate in targeted diseases like HIV and tuberculosis. Conclusion Most recommended enteral essential medicines in EMLc 2011 and 2019 were not age-appropriate for children <6 years. Medicines which are not age-appropriate must be manipulated before administration, leading to potential issues of safety and efficacy. Evaluation of the age-appropriateness of formulations for medicines to be included in EMLc could improve access to better medicines for children in the future.
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