Schirm E, Tobi H, de Vries T W, Choonara I, De Jong-van den Berg L T W
Groningen University Institute for Drug Exploration, Department of Social Pharmacy, Pharmacoepidemiology and Pharmacotherapy, Groningen, The Netherlands.
Acta Paediatr. 2003 Dec;92(12):1486-9. doi: 10.1080/08035250310006728.
Appropriate formulations are essential in pharmacotherapy. This study surveyed the use of different formulations by children in the community, and examined the reported lack of appropriate formulations (oral solutions) in relation to the licensing status of drugs.
A cross-sectional study based on 68,019 pharmacy dispensing records was performed in The Netherlands. For each prescription the formulation was assessed, and all prescriptions were categorized: unlicensed (no product licence), off-label (licensed drugs used outside the licence terms) and authorized (licensed drugs used according to the licence). The types of formulation used were assessed in relation to age and licensing status.
In all age groups, approximately half of all prescriptions were for oral drugs. The only major age-related trend was within oral drugs: younger children were more likely to be prescribed oral solutions. For authorized drugs the proportion of tablet/capsules exceeded oral solutions at the age of 7 y, whereas for off-label drugs this occurred at 3 y of age. For those medicines prepared by the pharmacy, tablets and capsules were more likely to be prescribed from the age of 9 y.
Many children in the community receive inappropriate oral formulations. Regulatory authorities and the pharmaceutical industry need to ensure that children have access to medicines with appropriate formulations.
合适的制剂在药物治疗中至关重要。本研究调查了社区中儿童对不同制剂的使用情况,并根据药物的许可状态研究了所报告的缺乏合适制剂(口服溶液)的情况。
在荷兰基于68019份药房配药记录进行了一项横断面研究。对每份处方的制剂进行评估,所有处方被分类为:未获许可(无产品许可)、超说明书用药(在许可条款之外使用的获许可药物)和获授权(根据许可使用的获许可药物)。根据年龄和许可状态评估所使用的制剂类型。
在所有年龄组中,约一半的处方是口服药物。唯一主要的与年龄相关的趋势存在于口服药物中:年龄较小的儿童更有可能被开具口服溶液。对于获授权药物,在7岁时片剂/胶囊的比例超过了口服溶液,而对于超说明书用药,这一情况在3岁时出现。对于药房配制的那些药物,从9岁起更有可能开具片剂和胶囊。
社区中的许多儿童接受了不合适的口服制剂。监管机构和制药行业需要确保儿童能够获得具有合适制剂的药物。