Giving Children the Correct Dose | Action Medical Research

Giving Children the Correct Dose

15 February 2001
Sheffield study adds weight to UK campaign New research in Sheffield has added extra ammunition to a national campaign calling for better understanding of medicines in children. A study led by the city’s university has revealed that infants’ under-developed intestines can absorb drugs differently than older patients, making them vulnerable to adverse reactions. The project, funded by leading medical charity Action Research, adds weight to its recent campaign launch, ‘Drug Treatment in Children: Children are not little adults’. The campaign calls for improved understanding of the effect of drugs on children. Action Research Training Fellow, Mr Trevor Johnson, led the Sheffield study, which found that small babies up to one-month-old have significantly less enzymes present in their gut than older children and adults. Mr Johnson, a paediatric pharmacist, says: ‘This may mean that they have an increased absorption of certain drugs and toxins ingested by mouth, placing them at greater risk of adverse drug effects. ‘This finding, coupled with other factors in this vulnerable age group is of importance for both our understanding and practice of paediatric pharmacology.’ Many medicines taken orally may be broken down by enzymes present in the intestine called Cytochrome P450 (CYP3A), which help break down the drug and reduce the amount reaching the blood. Mr Johnson’s team - based at the University of Sheffield and both the Children’s Hospital and Hallamshire Hospital, Sheffield - looked at how these enzyme activities change with age. The researchers studied the oral sedative, midazolam, in a group of children who were given the medicine prior to going to the operating theatre. The results showed that the level of the CYP3A enzyme did affect the blood level of oral midazolam. The two-year study also found that the increased absorption of certain drugs taken by mouth appears to be the same for patients who suffer from coeliac disease - whose small bowel is damaged by the effects of gluten in their diet. Although Dr Johnson emphasised that most children given the standard dose of midazolam had a safe blood level and were adequately sedated prior to surgery, he adds: ‘The results suggest that the newborn population is more vulnerable to an increased risk of side effects with some medicines. ‘This study is a piece of the wider jigsaw. Much work needs to be completed in the area of paediatric clinical pharmacology and I am pleased to see Action Research taking a lead.’ The charity launched its campaign in Belfast recently, where a team of Action Research funded scientists and clinicians are analysing the effects of numerous drugs which are not licensed or tested for use on children. Currently, 40% of drugs used in treating children are not licensed for that purpose, while 65% of drugs used on babies are being prescribed outside the terms of their licence - or are not licensed at all. The campaign, which is supported by the Consumers’ Association, urges the British Pharmaceutical Industry to make positive moves to gain a greater understanding of the effect of drugs on these young patients. For more details about the charity and its medical and fundraising campaigns visit the site at For further media and press information, please contact Nicole Duckworth or Duncan Barkes in the Action Research press office on 01403 327 403 /404 Fax: 01403 210541.
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