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WHO essential medicines for children 2011-2019: age-appropriateness of enteral formulations

Ebiowei Samuel F Orubu1, Jennifer Duncan2, Catherine Tuleu3

  • 1Biomedical Engineering, Boston University, Boston, Massachusetts, USA sforubu@bu.edu.

Archives of Disease in Childhood
|September 4, 2021
PubMed

Insights

Most essential enteral medicines on the WHO Essential Medicine List for children (EMLc) are not age-appropriate for young children. This lack of age-appropriate formulations requires manipulation, potentially impacting medicine safety and efficacy.

Area of Science:

  • Pediatric Pharmacology
  • Pharmaceutical Sciences
  • Public Health

Background:

  • The World Health Organization Essential Medicine List for children (EMLc) aims to improve access to essential medicines for pediatric populations.
  • Age-appropriateness of enteral formulations is critical for safe and effective pediatric dosing, considering factors like swallowability and dose adaptability.
  • There is limited data on the age-appropriateness of enteral medicines listed in the EMLc.

Purpose of the Study:

  • To evaluate the age-appropriateness of enteral (oral and rectal) formulations included in the WHO Essential Medicine List for children (EMLc).

Main Methods:

  • Assessed age-appropriateness of enteral formulations from the 3rd to 7th editions (2011-2019) of the EMLc for children under 12 years.
  • Stratified children into five age groups and evaluated formulations based on swallowability and dose adaptability.

Main Results:

  • Enteral formulations were generally more age-appropriate for older children (6-11 years) than for younger age groups.
  • For younger children, age-appropriateness decreased significantly with decreasing age, with only 15% of formulations suitable for neonates (0-27 days).
  • Formulations for specific diseases like HIV and tuberculosis showed higher age-appropriateness in the 7th edition.

Conclusions:

  • A majority of recommended enteral essential medicines in the EMLc (2011 and 2019) are not age-appropriate for children under six years old.
  • Non-age-appropriate formulations necessitate manipulation, potentially compromising medicine safety and efficacy.
  • Evaluating formulation age-appropriateness for EMLc inclusion can enhance future access to suitable pediatric medicines.
Abstract

Keywords:
health services researchpharmacology

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