Essential Medicines List For Children Research Articles

Pediatric Biopharmaceutical Classification System: Using Age-Appropriate Initial Gastric Volume.

Development of optimized pediatric formulations for oral administration can be challenging, time consuming, and financially intensive process. Since its inception, the biopharmaceutical classification system (BCS) has facilitated the development of oral drug formulations destined for adults. At least theoretically, the BCS principles are applied also to pediatrics. A comprehensive age-appropriate BCS has not been fully developed. The objective of this work was to provisionally classify oral drugs listed on the latest World Health Organization's Essential Medicines List for Children into an age-appropriate BCS. A total of 38 orally administered drugs were included in this classification. Dose numbers were calculated using age-appropriate initial gastric volume for neonates, 6-month-old infants, and children aging 1year through adulthood. Using age-appropriate initial gastric volume and British National Formulary age-specific dosing recommendations in the calculation of dose numbers, the solubility classes shifted from low to high in pediatric subpopulations of 12years and older for amoxicillin, 5years, 12years and older for cephalexin, 9years and older for chloramphenicol, 3-4years, 9-11 and 15years and older for diazepam, 18years and older (adult) for doxycycline and erythromycin, 8years and older for phenobarbital, 10years and older for prednisolone, and 15years and older for trimethoprim. Pediatric biopharmaceutics are not fully understood where several knowledge gaps have been recently emphasized. The current biowaiver criteria are not suitable for safe application in all pediatric populations.

Patterns of paediatric analgesic use in Africa: a systematic review

We conducted a systematic literature review with two objectives: (1) to assess reported patterns of analgesic use in African children and compare these observed patterns to the analgesics given in...

Availability, prices and affordability of the World Health Organization's essential medicines for children in Guatemala.

BackgroundSeveral World Health Organization (WHO) initiatives aim to improve the accessibility of safe and effective medicines for children. A first step in achieving this goal is to obtain a baseline measure of access to essential medicines. The objective of this project was to measure the availability, prices, and affordability of children’s medicines in Guatemala.MethodsAn adaption of the standardized methodology developed by the World Health Organization and Health Action International (HAI) was used to conduct a cross sectional survey to collect data on availability and final patient prices of medicines in public and private sector medicine outlets during April and May of 2010.ResultsA subset of the public sector, Programa de Accesibilidad a los Medicamentos (PROAM), had the lowest average availability (25%) compared to the private sector (35%). In the private sector, highest and lowest priced medicines were 22.7 and 10.7 times more expensive than their international reference price comparison. Treatments were generally unaffordable, costing as much as 15 days wages for a course of ceftriaxone.ConclusionsAnalysis of the procurement, supply and distribution of specific medicines is needed to determine reasons for lack of availability. Improvements to accessibility could be made by developing an essential medicines list for children and including these medicines in national purchasing lists.

WHO Essential Medicines List for Children

WHO Essential Medicines List for Children

Realities of paediatric pharmacotherapy in the developing world

Diseases causing high mortality in children under 5 years of age in resource limited settings (RLS) could be treated if children in these countries had access to existing medicines. It...

Delivering Better Medicines to Children

We are experiencing an exciting and unprecedented period in the history of children's medicines globally. Milestone developments unfolding in recent years include the formation of the International Alliance for Better Medicines for Children in 2006 and landmark initiatives by the EU, the World Health Assembly (WHA), and the WHO in 2007. However, the challenges of optimizing the development, wider availability, and routine use of effective, safe, and affordable medicines addressing important child health needs are considerable. Each aspect of this continuum has so far received differential attention. Major initiatives in the US and EU have focused on stimulating research into children's medicines, largely driven by drug regulatory reforms, but with important gaps remaining. Many countries are lacking similar reforms, so the benefits of these initiatives are currently not well reflected in the rest of the world. A systematic approach to knowledge translation to improve use of best evidence and deliver quality use of medicines (QUM) to children routinely has also been largely a 'missing link' so far. The WHO's Essential Medicines List for Children and related initiatives are addressing improving children's access to needed medicines. Priority research gaps, especially in the developing world, are also being pursued by the WHO. However, in many countries, including developed nations such as Australia, the policy response to the WHA resolution on 'Better Medicines for Children' has been inconsistent or fragmented. A better integrated overall approach, linking global medicines research efforts to child health needs and actual medicines use is needed. International networking to support the conduct, synthesis, and rapid dissemination of pediatric medicines research will help close knowledge gaps at a global level. Harmonization of pediatric drug regulation will support this goal and facilitate improving access to needed medicines. Increasing research into and dissemination of effective strategies to promote QUM is an essential component to maximize return (in health benefits) on increased investment in medicines research. A greater focus on QUM should also help create demand for better evidence from clinicians. Delivering on the promise of better medicines for children, wherever in the world they may be, depends on achieving successful integration between the science, the policy, and the practice of pediatric medicines.

Pediatric Pharmacotherapy Issues in Africa

Pediatric pharmacotherapy in Africa is constrained by a variety of factors, not all of them unique to the continent. While affordability of medicines and the availability of sustainable financing for healthcare are constant challenges to African health systems, other issues of particular importance for pediatric care are also hampering access. These include the burden of disease in such settings, the lack of appropriate human resources for health, and the lack of child-appropriate dosage forms, especially for ambulatory care. Access to medicines for children has been recognized as a global priority. Examples of developments that have the potential to improve pediatric pharmacotherapy in resource-constrained settings are the WHO Essential Medicines List for Children and the 'Make medicines child size' campaign.

Improving Drug Treatment for Children

At the beginning of 2009, we are on the threshold of mobilizing expertise in child health care and pediatric pharmacy and pharmacology in pursuit of worldwide major improvements in drug therapy for children. Momentum is built on progressive legislation on pediatric drug therapy from the US and Europe and on recent advances promoted by the WHO, including publication of an essential medicines list for children. Opportunities abound for research, educational initiatives, and practice improvements likely to bear early fruit in the form of better pharmacotherapy for children and youth. The most pressing challenge remaining is mobilization of a critical mass of caregivers, pharmacologists, pharmacists, and other child health professionals prepared to address their skills to this critically important task.

WHO to launch first essential medicines list for children

A list of essential paediatric medicines is sorely needed. The WHO essential medicines list, first launched in 1977, is predominantly for adults. It includes some dosages for children, but in most cases formulations for children simply do not exist.