Children: Introduction

Last updated: Thursday, July 09, 2015

 You can download a PDF of the text of this tutorial (it doesn't include the Learning Exercises).

This learning resource is not intended to be a comprehensive overview of drug use in children, more a summary of the most commonly encountered problems and suggestions on how to resolve them.

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Questions about medicines in children can present more of a challenge than questions about adult therapy because of the general lack of evidence in this age group, particularly with respect to finding suitable formulations and establishing safe, but effective doses.

The evidence base for the use of many medicines in children is often limited. Historically, many company sponsored drug trials have not recruited children because of ethical concerns and lack of financial return. It follows that the range of medicines that are licensed for use in children is restricted.

So if you are asked about the choice of drug in a paediatric patient, always consider if there is an appropriate, licensed option first. However, if the medicine required is not licensed for use in children you will need to take extra steps to check the indication, dose and frequency, suitability of formulation, precautions, interactions and monitoring parameters.

Several classification systems have been developed to define the age ranges in childhood. A  commonly used method is as follows:

  • Neonate – first 28 days of life.

  • Infant – from 1 month to 1 year.

  • Child – from 1 year to 12 years.

Therefore, for the purpose of medicine administration, children over the age of 12 years are often considered as adults. This is not always appropriate as many 12-year-olds are not adult height and weight, and have not reached puberty.

Unfortunately, manufacturers of medicines and regulatory authorities have yet to standardise the age groups referred to in Summaries of Product Characteristics (SPCs).