第7版《WHO儿童基本药物示范目录》在儿童医院的使用情况分析

Analysis on the use of WHO Model List of Essential Medicines for Children(7th Edition)at children’s hospitals

目的:基于样本儿童医院药品使用情况,为制定中国儿童基本药物目录提供参考。方法:利用18家三级儿童专科医院的药品采购数据,比较分析第7版《WHO儿童基本药物示范目录》(EMLc)与样本儿童医院用药在品种和剂型上的异同,根据欧洲药品管理局推荐的儿童用药剂型,分析不同年龄儿童适宜用药剂型的分布情况。结果:儿童医院用药与《WHO儿童基本药物示范目录》重合的活性成分191个,重合率64.3%,重合的品种247个,重合率75.3%。儿童医院使用较广泛的剂型分别为静脉注射剂(41.3%)、口服片剂(24.9%),用药金额占比最高药品类别为抗感染药物(34.0%),用药金额占比最高的药品为人免疫球蛋白(16.8%);适宜新生儿和婴幼儿使用的泡腾剂、栓剂和灌肠剂较少。结论:儿童专科医院的用药情况与EMLc存在差异,部分类别药品剂型缺乏,在制定中国儿童基本药物目录时,可借鉴EMLc相对成熟的遴选原则,结合我国儿童临床用药实际情况,并充分考虑儿童在药物剂型和规格上的特殊需求,提高我国儿童用药的安全性、合理性。

OBJECTIVE To provide references for the formulation of essential medicines for children in China through analyzing use of medicines at children’s hospitals.METHODS The drug purchase data of 18 tertiary children’s hospitals were reviewed.And the differences in varieties and dosage forms between the 7 th Edition of WHO Model List of Essential Medicines for Children(EMLc)and participating children’s hospitals were compared.RESULTS There were 191(64.3%)active ingredients coincident between EMLc and children’s hospitals and 247(75.3%)varieties were coincident.The dosage forms widely used at children’s hospitals were intravenous injection(41.3%)and oral tablet(24.9%).The drug category with the highest proportion of drug amount was anti-infective drugs(34.0%)and human immunoglobulin(16.8%)had the highest variety.Few effervescent agents,suppositories and enemas were suitable for neonates and infants.CONCLUSION Some differences in medicine usage exist between children’s hospitals and EMLc and some categories lack pharmaceutical dosage forms.While formulating the Chinese list of essential medicines for children,we can learn from the relatively mature selection principles of EMLc,consider the actual situation of children’s medication in China and accommodate special needs of children in terms of drug dosage forms and specifications so as to improve the safety and rationality of medicine for children in China.