Bonati M
Perinatal Clinical Pharmacology Unit, Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy.
J Clin Pharmacol. 1994 Apr;34(4):300-5. doi: 10.1002/j.1552-4604.1994.tb01997.x.
To define and evaluate the attention devoted to drug use in children rather than just review existing reviews, the present attempt is to seek out the primary sources of information in the hope that this effort would not only yield more reliable data, but would also provide an opportunity for reconsidering methodological problems which are possibly even more important. An English-language literature search for drug use in children from 1988 was conducted on two databases and a manual search was made of the literature, with a check of references quoted in main original articles, reviews and textbooks. The review was then organized in two main sections: an overall evaluation of the recent literature concerning drug use in children; the epidemiological profile of drug exposure as described cumulatively by the drug-utilization studies. A substantial lack of systematic attention to this area of drug epidemiology was found: drug use in the children is a 'hidden' reality in the literature; the wealth of methodologic developments that have taken place in the general field of drug use monitoring has scantly reached children. Children can be considered still "methodologic orphans" with respect to the transferable knowledge on the benefit/risk profile of therapies they receive. A network has to be developed to monitor clinical problems, including drug use, as part of an "audit" of the overall management of children.
为了界定和评估对儿童用药问题的关注程度，而不仅仅是回顾现有的综述，本研究试图找出主要的信息来源，希望这一努力不仅能产生更可靠的数据，还能为重新审视可能更为重要的方法学问题提供机会。我们在两个数据库中对1988年以来关于儿童用药的英文文献进行了检索，并对文献进行了手工检索，同时检查了主要原创文章、综述和教科书中引用的参考文献。然后，本综述分为两个主要部分：对近期有关儿童用药文献的总体评价；药物利用研究累积描述的药物暴露流行病学概况。我们发现，在药物流行病学这一领域，人们对其缺乏系统的关注：儿童用药在文献中是一个“隐藏”的现实；药物使用监测总体领域中丰富的方法学进展几乎没有涉及到儿童。就儿童所接受治疗的获益/风险情况的可转移知识而言，儿童仍可被视为“方法学上的孤儿”。必须建立一个网络来监测临床问题，包括用药问题，作为对儿童总体管理“审计”的一部分。
