Paediatric prescribing in out-patient care. An example from Sri Lanka.

Few drug utilization studies have been focused on children in developing countries, where they constitute a large part of the total population. The present study describes prescribing in 5 outpatient departments (15 practitioners) in an area of Sri Lanka over a period of seven months. It includes a random sample of 2484 paediatric consultations. On average, 2.7 drugs were prescribed per patient. With a few exceptions generic prescribing of oral drugs prevailed, and only 1% of the children were given injections. In all, 107 different products were used. Antipyretics, antihistamines, antibiotics and sulphonamides were the most commonly used classes of drugs, being prescribed for 40-50% of the children. Penicillin V represented 43% of the total antibiotic prescribing. Only 1.2% of the children and 0.5% of the infants were given tetracycline. Paracetamol was the preferred antipyretic drug in infants. The use of injectables and tetracycline in children has been reported to be common in other developing countries. The practitioners in Sri Lanka showed a more rational prescribing pattern with the exception of the frequent use of antihistamines, cough medicine and an antiflatulent. The need to develop a paediatric drug policy is discussed.