# \[e-drug\] Drug formulations suitable for use in children (cont'd) **URL:** \ **Category:** e-drug\ **Created:** [July 7, 2004, 12:15am UTC](https://talk.edrugplus.org/t/e-drug-drug-formulations-suitable-for-use-in-children-contd/20070 "2004-07-07T00:15:40Z")\ **Posts on this page:** 1\ **Page:** 1
**Author:** ![david.woods](https://avatars.discourse-cdn.com/v4/letter/d/67e7ee/32.png) [@david.woods](https://talk.edrugplus.org/u/david.woods)\ **Post date:** [July 7, 2004, 12:15am UTC](https://talk.edrugplus.org/t/e-drug-drug-formulations-suitable-for-use-in-children-contd/20070/1 "2004-07-07T00:15:40Z")
E-drug: Drug formulations suitable for use in children (cont'd) --------------------------------------------- Dear Atieno, Yes I agree this is a big problem. I recently presented a poster on this at ICIUM in Thailand (See text of abstract below). I now have more data and I am in the process of writing this up for publication. I am also putting the database on a web site so it can be accessed free of charge. I hope that feedback from practitioners in developing countries will help me to make it relevant and useful to all. See [http://pharminfotech.co.nz/manual/Formulation/oral.htm](http://pharminfotech.co.nz/manual/Formulation/oral.htm) Qualitatively we can say that these practices are widespread including compounding of digoxin liquid, antimalarials, rifampicin, antibiotics and many others. Safety and efficacy are real issues and these practices may seriously compromise patient care and outcomes. This is difficult to quantify but the enquiries I get can't be ignored. Problems are of course exacerbated by access, cost and registration processes. The other issue is education of practitioners on alternatives to compounding such as tablet dispersion etc. I am very keen to work with anyone to develop some useful guidelines that could be circulated to help resolve some of these problems. Regards, David Woods Consultant Pharmacist University of Otago Dunedin NEW ZEALAND   David Woods \ Access to Pediatric Formulations in Developing Countries Woods, D. J.1 1PharmInfoTech Ltd. (NZ), School of Pharmacy, University of Otago, Dunedin, New Zealand Background Oral liquid preparations for the administration of doses to children are not freely available. Consequently, pharmacists frequently have to modify solid dose forms. Information on the stability of these formulations is often lacking, difficult to find, inconsistent, or only applicable for use in a handful of developed countries. Information on the situation in developing countries is lacking, but anecdotally it has been ascertained that the use of substandard preparations for the treatment of tuberculosis, HIV/AIDS, and malaria is widespread. Objective This study was designed to gather some preliminary data and to suggest strategies for improvement. Method In the first stage in April 2000, a CD-ROM database was developed with a companion Web site. To date, the CD has been distributed to more than 40 countries. The database is sent free of charge to developing countries. Each CD was accompanied by a letter inviting comments and information requests. Specifically, pharmacists were invited to request information about formulations not included in the database, and to comment on problems specific to their country of practice. A Web page for updates to the database was revised regularly. In the second stage (in progress), specific developing countries are being targeted for more detailed analysis of problems and practices. Results Data for the first stage of the study were collated for the period April 2001 through March 2003. A total of 269 information requests were received from 28 countries. The requests involved more than 30 different drugs. Important general and country-specific problems have been identified. Lack of commercial products and information on extemporaneous formulations are contributing to suboptimal treatment in many countries. Examples of problems include: 1. Compounding of antiretroviral liquids from tablets is a common practice, even though data on stability are lacking. 2. Many practitioners in developing countries have to compound liquids for treatment of tuberculosis, malaria, HIV/AIDS, and cardiovascular disease without guarantee of effectiveness. Commercially manufactured products are widely available in developed countries. 3. Availability of pediatric formulations in developing countries may be hindered by drug company policy and registration processes. Conclusion Many developing countries have poor access to commercially manufactured pediatric formulations. Practices for compounding are inconsistent, and the problems are exacerbated by lack of ingredients and information. Strategies to improve the situation include international guidelines, increased availability of information, practitioner education, and improved liaison between drug companies and regulatory authorities. -- To send a message to E-Drug, write to: e-drug@healthnet.org To subscribe or unsubscribe, write to: majordomo@healthnet.org in the body of the message type: subscribe e-drug OR unsubscribe e-drug To contact a person, send a message to: e-drug-help@healthnet.org Information and archives: [http://www.essentialdrugs.org/edrug](http://www.essentialdrugs.org/edrug)