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Availability of age-appropriate paediatric formulations in the Netherlands: the need in daily clinical practice remains
  1. Anna van der Vossen1,
  2. Sandra Buljaç1,
  3. Kadir Akçay1,
  4. Jan Dietert Brugma2,
  5. Arnold Vulto1,
  6. Lidwien Hanff1,3
  1. 1Department of Hospital Pharmacy, Erasmus Medical Center, Rotterdam, The Netherlands
  2. 2Department of Outpatient Pharmacy, Erasmus Medical Center, Rotterdam, The Netherlands
  3. 3Department of Hospital Pharmacy, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
  1. Correspondence to Mr Jan Dietert Brugma, Outpatient Pharmacy, Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands; j.brugma{at}erasmusmc.nl

Abstract

Objectives To quantify the availability of authorised, age-appropriate paediatric medicines in clinical practice in the Netherlands and to identify gaps by assessing dispensing practice in a paediatric hospital.

Methods The availability of age-appropriate formulations was assessed by conducting a survey on the use of pharmacy compounded medicines among the paediatric hospitals in the Netherlands, and by analysing dispensing data of oral medication from the inpatient pharmacy of the largest paediatric hospital in the Netherlands. The age-appropriateness of the dispensed formulations was assessed on two aspects: dose-capability and acceptability. Liquid drug products that are unsuitable due to the presence of potentially harmful excipients, were identified based on the dosage in clinical practice.

Results For 129 out of 139 drug substances included in the survey (93%), at least one of the eight respondents stated to use a pharmacy compounded product to meet the needs of their paediatric patients. The age-appropriateness of medicines dispensed from the inpatient pharmacy increased with age, and was higher for non-intensive care unit (ICU) patients than for ICU patients. We identified 15 drug products causing excipient exposure above the European Medicines Agency-recommended values.

Conclusions This study confirms there is still a large need for age-appropriate formulations in daily clinical practice. Pharmacy compounding for paediatric patients remains essential for many indications. The need for potentially harmful excipients in compounded products should be critically assessed.

  • paediatric formulations
  • compounding
  • excipients
  • availability

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

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