Background: Frequent prescription of medication in an unapproved manner (off-label or unlicensed) in the neonatal setting is a result of the limited availability of adequately studied drugs in the pediatric population. Given that little information is available on this issue from eastern European countries, the purpose of this study was to describe for the first time the extent and pattern of off-label or unlicensed use of medicines in newborns in the Slovak Republic.
Methods: Cross-sectional study was performed at the Department of Pathological Newborns of Children's University Hospital, Bratislava, and Unit of Pathological Newborns of Teaching Hospital Nitra. Data were collected on hospitalized neonates admitted between 1 April and 30 September 2012 who received pharmacotherapy. Label status of the administered drugs was determined according to the Slovak Summaries of Product Characteristics.
Results: A total of 962 prescriptions referring to 97 different medications was administered to 202 hospitalized newborns (46% premature). Anti-infectives and alimentary drugs were the most commonly prescribed. Of all prescriptions, 43% were identified as off-label and 4.8% as unlicensed. At least one off-label or unlicensed drug was given to 88.6% of patients. Ketoconazole was the most frequent drug used in an unapproved manner. A total of 13.8% of all prescriptions was administered despite contraindication.
Conclusions: Administration of drugs to newborns in an unapproved manner was common in the participating Slovak neonatal wards, reflecting the lack of appropriate pediatric drug labeling.
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http://dx.doi.org/10.1111/ped.12771 | DOI Listing |
Integr Pharm Res Pract
November 2024
Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, Wales, UK.
Background: The use of unlicensed medicines has been associated with safety concerns, availability and accessibility issues, and lack of integrated care across care settings.
Objective: To understand the interaction between the views and experiences of those who prescribe, those who supply and those who receive unlicensed "special" medicines, so that factors affecting the patient journey and successful treatment can be identified and used to inform areas for change.
Methods: A qualitative, phenomenological approach was adopted, with semi-structured interviews with prescribers, community pharmacy staff and patients.
Exp Ther Med
November 2024
Department of Medical Microbiology, Central South University, Changsha, Hunan 410078, P.R. China.
Despite legislative enforcement on authorized drugs, off-label and unapproved pediatric drug use is prevalent. The present study aimed to assess the global prevalence of off-label and unlicensed prescriptions among hospitalized children via meta-analysis. A comprehensive examination of articles published between 1990 and 2023 from the PubMed, Scopus, Excerpta Medica Database, Web of Science and Google Scholar databases was conducted.
View Article and Find Full Text PDFCurr Pediatr Rev
September 2024
Niger Delta University, Pharmacy Department, Yenagoa, Bayelsa State, Nigeria.
Background: The global lack of suitable formulations for children leads to off-label and unlicensed medicine use, posing significant risks of adverse effects. Understanding this usage on a national level can help guide interventions for better formulations. This study aimed to measure the prevalence of off-label and unlicensed medicines among children in South Africa's private sector.
View Article and Find Full Text PDFWorld J Pediatr
August 2024
Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy, University of Seville, C/Professor García González, 2, 41012, Seville, Spain.
Background: Global pediatric healthcare reveals significant morbidity and mortality rates linked to respiratory, cardiac, and gastrointestinal disorders in children and newborns, mostly due to the complexity of therapeutic management in pediatrics and neonatology, owing to the lack of suitable dosage forms for these patients, often rendering them "therapeutic orphans". The development and application of pediatric drug formulations encounter numerous challenges, including physiological heterogeneity within age groups, limited profitability for the pharmaceutical industry, and ethical and clinical constraints. Many drugs are used unlicensed or off-label, posing a high risk of toxicity and reduced efficacy.
View Article and Find Full Text PDFExpert Rev Clin Pharmacol
September 2024
Department of Pharmaceutical and Pharmacological Sciences, Leuven, Belgium.
Introduction: Assessment of drug-related adverse events is essential to fully understand the benefit-risk balance of any drug exposure, weighing efficacy versus safety. This is needed for both drug labeling and clinical decision-making. Assessment is based on seriousness, severity and causality, be it more difficult to apply in neonates.
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