Jacobsen Laura, Riley Kathy, Lee Brian, Bradford Kathleen, Jhaveri Ravi
Division of Pediatric Infectious Diseases, Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, 2242 Genome Sciences Bldg, CB#7231, 250 Bell Tower Dr, Chapel Hill, NC, 27599-7231, USA.
Eschelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Paediatr Drugs. 2016 Feb;18(1):65-73. doi: 10.1007/s40272-015-0156-y.
Children are frequently asked to take tablets and capsules of different sizes and shapes to manage acute and chronic medical conditions. Medication size is an important factor that contributes to compliance, yet few studies detail size variation or pediatric pharmacy inventory.
This study assesses the available sizes and size variations of common inpatient and outpatient pediatric medications and provides an inventory of the tablet and capsule sizes available in a children's inpatient hospital pharmacy.
We derived the most frequently prescribed oral medications from US national databases, including the IMS, Vector One(®): National (VONA) and Pediatric Health Information System (PHIS). We analyzed a composite list using the National Library of Medicine Pillbox website, which provides size measurements. Medications from a children's inpatient pharmacy were audited and hand measured for comparison.
We created a list of the top 15 most prescribed inpatient and outpatient pediatric tablet/capsule medications and observed a wide variation in size: acetaminophen 500 mg ranged from 5 to 22 mm in length, median 15 mm. Common pediatric antibiotics were larger and ranged from 8 to 25 mm in length, median 17 mm. Hand-measured samples from the inpatient pharmacy were often the larger pill sizes, despite smaller alternatives being available.
We observed a marked variation in the sizes of common pediatric tablet/capsule medications, and pharmacies that serve children may not stock the most child-friendly medications. Tablet/capsule size does not appear to be considered when decisions about tablet and capsule medication selections are made. These results should increase awareness of these sizes and affect how physicians prescribe, how pharmacies order inventory, and how insurers and pharmaceutical companies pay for and produce pediatric medications.
儿童经常需要服用各种大小和形状的片剂和胶囊来治疗急慢性疾病。药物的大小是影响依从性的一个重要因素，但很少有研究详细说明药物大小的差异或儿科药房的库存情况。
本研究评估常见住院和门诊儿科药物的可用尺寸及其变化情况，并提供一家儿童住院药房中片剂和胶囊的尺寸清单。
我们从美国国家数据库中获取最常开具的口服药物，包括IMS、Vector One(®): National（VONA）和儿科健康信息系统（PHIS）。我们使用美国国立医学图书馆药盒网站分析了一份综合清单，该网站提供尺寸测量数据。对一家儿童住院药房的药物进行了审核并手工测量以作比较。
我们列出了最常开具的15种住院和门诊儿科片剂/胶囊药物清单，并观察到尺寸差异很大：对乙酰氨基酚500毫克片剂长度从5毫米到22毫米不等，中位数为15毫米。常见的儿科抗生素片剂更大，长度从8毫米到25毫米不等，中位数为17毫米。尽管有更小尺寸的替代品，但住院药房手工测量的样本通常是较大尺寸的药片。
我们观察到常见儿科片剂/胶囊药物的尺寸存在显著差异，为儿童服务的药房可能没有储备最适合儿童的药物。在选择片剂和胶囊药物时，似乎没有考虑到片剂/胶囊的大小。这些结果应提高对这些尺寸的认识，并影响医生的处方方式、药房的库存订购方式以及保险公司和制药公司对儿科药物的支付和生产方式。
