E-DRUG: RFI: paracetamol AND ibuprofen in children? (4)
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Dear e-druggers
Darren Roberts has hit on the key question - the common problem is the
febrile child.
I tried to address this in a paper I wrote for the South African Family
Practice journal in 2002 (Gray A. Quality use of medicines - the febrile
child. South African Family Practice 2002; 25(5): 33-35). The paper was
sparked by an exchange on this list in January 1998 about diclofenac and
mefenamic acid use in children.
Below are some points from that paper (with the references inserted).
This is an area of practice where multi-component products (FDCs) reign
supreme. For example, a review of prescriptions for 47 103 members of a
single South African medical aid (health insurance company or third party
payer) in 1995 showed that analgesics accounted for 12.3% of all items
prescribed (and 14.2% of costs) (Truter I. Patterns of analgesic prescribing
in a South African primary care setting. J Clin Pharm Ther 1997; 22(1):
33-337). Almost all such prescriptions (93.8%) were for non-opioid
analgesics. Of these, 31.6% were for children aged less than 10 years. The
15 most frequently prescribed products accounted for 56.4% of all analgesic
prescriptions, with the top 3 being the same brand-name multi-component
product (containing paracetamol, codeine and promethazine in syrup form, and
paracetamol, codeine, caffeine and meprobamate in the capsule and tablet
forms; Stopayne�), together responsible for 23.4% of all analgesic
prescriptions. Multi-component products made up 11 of the top 15. It is
likely than much of this paediatric prescribing was for fever, with or
without pain. It is also likely that a prescription audit today would show
an equally alarming trend towards newer multi-component products, perhaps
combining paracetamol and an anti-inflammatory (with or without codeine).
regards
Andy