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First world-standard guide on medicines for children

For the first time medics across the world will be able to check standardised guidelines when giving medicines to children.

The World Health Organisation (WHO) has just released the first Formulary for Children, which has rules of thumb on how to use more than 240 essential medicines for treating in children.

It is the first time medics worldwide will be able to refer to standard information on the recommended use, dose, side-effects, and contraindications of these medicines in babies through to children the age of 12. For instance the guide says that ibuprofen, commonly given to children to treat pain, can have bad interactions when taken with any one of twenty-one listed medicines

"To be effective, medicines must be carefully chosen and the dose adjusted to suit the age, weight and needs of children," said the WHO’s Dr Hans Hogerzeil. "Without a global guide, many health-care professionals have had to prescribe medicines based on very limited evidence."

The new guide, he said, is based on the best global evidence available as to which medicines should be used to treat specific conditions, how they should be administered and in what dose. “Accurate dosing of medicines for use in children is essential, particularly those between 0-12 months. A dosing error in a child this small can have devastating results.”

With medicines used to treat malaria or HIV, the guide highlights the need for one pill that combines several medicines. At the moment there’s very few of these combination pills for very few fixed dose for children.

Each year 8.8 million children under five die, according to the WHO, which says many of these deaths are caused by diseases which could be avoided by using safe essential medicines made especially for children. These include diarrhoea and pneumonia as well as conditions such as severe bacterial infections in newborn babies.

Lack of child-size medicines is a global problem, which affects developing countries the most. Worldwide many medicines for children are used ‘off-label’, which means that their effects on children have not been studied and they are not licensed for use in children. When child specific medicines are not available, healthcare workers and parents often use fractions of adult doses or make doses for children by crushing tablets or dissolving portions of capsules in water. This is difficult for the parent or care-giver, can be hard for the child to take and can result in under or over dosing the child.

Hayley attribution