Medicamentos utilizados en pediatría extrahospitalaria: ¿disponemos de información suficiente?

{ "0" : "Servicio de Pediatría. Consorcio Hospital General Universitario. Consorcio Hospital General Universitario. Valencia. España" , "1" : "Centro de Salud. Aldaia. Consorcio Hospital General Universitario. Valencia. España" , "2" : "Centro de Salud. Tavernes Blanques. Consorcio Hospital General Universitario. Valencia. España" , "3" : "Departamento de Farmacología. Universidad de Valencia. Consorcio Hospital General Universitario. Valencia. España" , "4" : "Unidad de Farmacología Clínica. Consorcio Hospital General Universitario. Valencia. España" , "6" : "Utilización de medicamentos" , "7" : "Información de medicamentos" , "8" : "Uso no autorizado" , "9" : "Niños" , "10" : "Drug use" , "11" : "Drug information" , "12" : "Off-label use" , "13" : "Children"}
Anales de Pediatría (Impact Factor: 0.83). 05/2008; 68(5):439-446. DOI: 10.1157/13120040


ObjetivoAnalizar los medicamentos que reciben los pacientes pediátricos en el ámbito extrahospitalario y la información disponible sobre los mismos.Pacientes y métodosEstudio transversal, observacional y descriptivo realizado en una muestra de pacientes menores de 14 años atendidos en urgencias del Servicio de Pediatría del Consorcio Hospital General Universitario de Valencia entre junio 2005 y agosto 2006. Se cuantifican y clasifican los medicamentos utilizados antes de acudir a urgencias y se analiza la información sobre su uso que contiene el Vademécum Internacional Medicom y la ficha técnica.ResultadosSe recogió información sobre 462 niños con media de edad de 5,2 años (intervalo de confianza del 95% [IC 95%]: 4,9-5,6). De ellos, 336 reciben 667 medicamentos (152 distintos) que contienen 864 principios activos (161 diferentes). En el 34,3 % de los casos el uso es por automedicación. Los menores de 4 años reciben medicamentos en mayor proporción que los mayores (80,2 y 67,4%, respectivamente). Los pacientes reciben entre 1 y 7 medicamentos (media 2,0). Los que toman 2 o 3 medicamentos son menores que los que toman uno. Cinco grupos terapéuticos de la Clasificación anatómico-terapéutico-química (ATC) incluyen el 93,1% de los medicamentos (R [aparato respiratorio]: 26,5%; M [aparato locomotor]: 23,8%; N [sistema nervioso central]: 22,8 %;J [antiinfecciosos por vía general]: 10,6% y A [aparato digestivo y metabolismo]: 10,0%). Para 40 de los 152 medicamentos no hay información pediátrica en las fuentes consultadas.ConclusionesCasi tres cuartas partes de los niños atendidos en urgencias toman medicamentos antes de acudir a este servicio, en muchos casos por automedicación. La información sobre uso pediátrico de medicamentos es incompleta y presenta incongruencias. Es necesario fomentar la investigación clínica sobre los efectos del tratamiento farmacológico en los niños para mejorar la información sobre su uso.ObjectiveTo analyse the drugs taken in paediatric outpatients and the information available on these drugs.Patients and methodsA cross-sectional, observational, descriptive study was carried out. The study involved a sample of children under 14 years seen in the Emergency Room of the HGUV from June 2005 to August 2006. The medicines they received were quantified and classified, and the information on these drugs available in the Vademecum International Medicom and in the Summary of Product Characteristics, were analysed.ResultsOf the 462 children (mean age 5.2 (95% CI 4.9-5.6)) in-cluded, 336 received 667 medicines (152 different medicines) that contained 864 drugs (161 different drugs). In 34.3 % of the cases it was for self-medication. Children under 4 years received more drugs than the older group (80.2% in the younger group and 67.4% in the older). Patients received from 1 to 7 medicines (mean 2.0). Children receiving 2 or 3 medicines were younger than those who received one. Five therapeutic groups of the Anatomical-Therapeutical-Chemical Classification (ATC) include the 93.1% of the drugs administered (R: 26.5%; M: 23.8%; N: 22.8%; J: 10.6% and A: 10.0%). In the information sources consulted there was no information available on paedi-atric use for 40 of the 152 medicines used.ConclusionsAlmost 75 % of patients seen in the Emergency Room were already receiving drugs before they arrived at the hospital, in many cases as a result of self-medication. The information available on the paediatric use of drugs is deficient. Clinical research is required to study the effects of pharmacological treatment on children and to improve the information on their use.

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