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儿童基本药物世界卫生组织清单与巴西基本药物清单(更名)的对比评估

A critical comparison between the World Health Organization list of essential medicines for children and the Brazilian list of essential medicines (Rename).

机构信息

Programa de Pós-graduação em Ciências Farmacêuticas, Universidade Federal do Ceará UFC, Fortaleza, CE, Brazil.

出版信息

J Pediatr (Rio J). 2013 Mar-Apr;89(2):171-8. doi: 10.1016/j.jped.2013.03.004.

DOI:10.1016/j.jped.2013.03.004
PMID:23642428
Abstract

OBJECTIVE

To perform a critical comparison between the Brazilian national essential medicines list (Rename, 2012) with the list of essential medicines for children (LEMC, 2011) of the World Health Organization (WHO), regarding the differences among drugs and formulations listed for children.

METHODS

The LEMC drugs were classified into four categories: 1) absent in Rename; 2) included in Rename but without any formulation suitable for children; 3) listed in Rename only in some formulations; 4) present in Rename in all formulations. The missing formulations were analyzed by therapeutic group. Alternatives present in Rename were searched.

RESULTS

From the 261 drugs of interest on the LEMC, 30.3% are absent from Rename, 11.1% are in Rename but without any pediatric formulation, and 32.2% are present in some but not all formulations listed in LEMC. Considering all formulations items listed in the LEMC (n = 577), 349 are missing from Rename, of these 19.6% due to their strength, and 18.5% due to the the dosage form. Useful formulations specific for neonatal care, respiratory tract, central nervous system, and anti-infectives, among other groups, are missing.

CONCLUSION

The lack of age-appropriate formulations of essential medicines for children in Brazil includes important therapeutic groups and indispensable drugs for severe clinical conditions. Some of these products exist in the Brazilian pharmaceutical market, but not in public facilities; others could be produced by national laboratories with commercial interest or stimulated by a specific governmental policy, as in other countries.

摘要

目的

对巴西国家基本药物清单(Rename,2012 年)与世界卫生组织(WHO)儿童基本药物清单(LEMC,2011 年)进行批判性比较,比较两者列出的儿童用药和制剂之间的差异。

方法

将 LEMC 药物分为以下四类:1)在 Rename 中不存在;2)包含在 Rename 中,但没有任何适合儿童的制剂;3)仅在 Rename 中列出某些制剂;4)在 Rename 中所有制剂都存在。对缺少的制剂按治疗组进行分析。寻找 Rename 中存在的替代制剂。

结果

在 LEMC 中,有 261 种感兴趣的药物,其中 30.3%不存在于 Rename 中,11.1%存在于 Rename 中,但没有任何儿科制剂,32.2%存在于 Rename 中列出的一些制剂,但不是所有制剂。考虑到 LEMC 中列出的所有制剂项目(n=577),Rename 中缺少 349 种,其中 19.6%是由于其强度,18.5%是由于制剂形式。缺少新生儿护理、呼吸道、中枢神经系统和抗感染等重要治疗组和严重临床情况下不可或缺的药物的特定制剂。

结论

巴西儿童基本药物缺乏适合年龄的制剂,其中包括重要的治疗组和严重临床情况下不可或缺的药物。这些产品中的一些在巴西制药市场中存在,但不在公共设施中;其他产品可以由具有商业利益的国家实验室生产,或在特定政府政策的刺激下生产,就像其他国家一样。

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