Use of unlicensed drugs may be recommended in guidelines

EDITOR—Conroy et al report the widespread use of drugs that are either not licensed for use in children or are prescribed outside the terms of their product licence (off label prescribing) in children admitted to hospital.1 Although it is not illegal to use medicines in this way, the responsibility for any adverse events becomes the clinician's or the pharmacist's rather than the manufacturer's. However, much unlicensed use may be recommended in local or national guidelines.

As part of our trust's response to the use of unlicensed drugs in children, I reviewed all drugs recommended in our local paediatric medical guidelines. These contained 69 guidelines for acute management and elective investigation of children. The guidelines recommended 86 drugs, but only 47 (55%) were licensed for use in children. A further 14 drugs were licensed only for children above a certain age or …