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What's the matter with our little customers and what do they use? Epidemiology of illnesses and drug utilization by children
Abstract
In the present article epidemiological data on the most frequently occuring illnesses in children are presented. On the basis of pharmacy prescription data of the Pharmo database, pharmacoepidemiological data of the use of drugs by children are also given. In 1998 40,708 (63%) of 64,881 children were prescribed at least one drug. The prevalence of the use of drugs from the ATC classes antibiotics for systemic use, drugs for the respiratory system and dermatological preparations was highest with 24.1%,24.1% and 20.9%, respectively.The use was lowest for drugs from the classes oncolytics, cardiovascular drugs and gynaecological drugs with 0.08%, 0.7% and 0.9%, respectively. The use of amoxicillin, paracetamol and salbutamol amounted to 16.9%, 12.8% and 4.8%, respectively.
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The aim of this study was to determine whether use of antiparkinsonian drugs in pharmacy records can be used as a marker for patients with Parkinson's disease (PD).
Data were obtained from the Rotterdam Study, a community-based prospective cohort study among people aged 55 years or older who were all screened for PD. For 5510 persons, of whom 74 had PD, pharmacy records were available. Stepwise logistic regression analysis was used to evaluate whether age, sex and use of the antiparkinsonian drugs amantadine, anticholinergics, dopamine agonists, levodopa and selegiline, were predictive variables for PD. For each individual a probability for having PD was calculated. Sensitivity, specificity and positive predictive value (PPV) were calculated at different cut-off values based on calculated probabilities.
More than 90% of the users of levodopa, bromocriptine, selegiline, and users of at least two different antiparkinsonian drugs had PD. Age, use of amantadine, anticholinergics, bromocriptine, levodopa, and selegiline were predictive variables for PD. After application of different cut-off values, sensitivity was at most 66.2%, and specificity was at least 99.8%. A PPV of higher than 90% was obtained at higher probabilities.
Based on the high PPV of our predictive model, antiparkinsonian drugs can be used as a reliable marker for PD in pharmacy records. Because sensitivity is low, pharmacy records cannot be used to estimate prevalence of PD.
Although in the Netherlands the incidence of the sudden infant death syndrome is low (0,17/1000 liveborn babies), each year still 30 babies die. Known risk factors are: the sleeping position of the baby on its tummy or its side, eiderdowns, cushions, undersheets, soft matrasses, and sleeping with the parents on a sofa. Furthermore, a relation is found between parents smoking and sudden infant death syndrome. There is a limited amount of information on a connection between drug use and sudden infant death syndrome. The use of sedative antihistaminics should be avoided by young children. Preventive actions are the use of an infant's sleeping bag and of a dummy.