Editorials

Prescribing medicines for children

BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7202.70 (Published 10 July 1999) Cite this as: BMJ 1999;319:70

Major problems exist, but there are some promising developments

  1. Alastair G Sutcliffe, Lecturer in child health (icsi@rfhsm.ac.uk)
  1. Royal Free and University College Hospital Medical School, University College London, Royal Free Campus, London NW3 2PF

    All parents would like the drugs administered to their child to have been fully evaluated using studies based in children (but not their child). However, infants and older children present a challenge for drug monitoring and testing, and there are far fewer clinical studies designed to test drugs in children than to test them in adults. The factors that limit such studies include technical constraints such as blood sampling. There are also ethical difficulties in involving children in studies that may not directly benefit them, even if the studies involve minimal risk. Fortunately, with the development of new non-invasive methods to measure drug concentrations therapeutic drug monitoring will be less limited by the necessity for blood sampling.1 Moreover, drug regulatory authorities and professional bodies are beginning to address the need to test drugs for children in the same way as those for adults.

    The disposition of drugs in children varies from that in adults because children differ from adults pharmacokinetically and pharmacodynamically. Factors such as growth, surface area, organogenesis, enzyme …

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