PHARMACOLOGY Essential Medicines List for Children: First Report on Proposed Essential Medicines for Neonates

Introduction: Despite the technical advances that have been achieved, many gaps related to neonatal health care remain globally. The substantial lack of evidence regarding the efficacy and safety of many medicines used in the treatment of neonates and the scarcity of appropriate formulations for this age group was recognized during the First Meeting of the World Health Organization (WHO) Subcommittee of the Expert Committee on the Selection and Use of Essential Medicines in July 2007. Therefore, a review was conducted to identify potential essential medicines for neonates to be considered for inclusion in the Essential Medicines List for Children (EMLc). This list will ultimately improve suboptimal prescribing and dosing of medicines in this vulnerable age group by guiding national formularies and contribute to a public health oriented research agenda by identifying research gaps. Material and Methods: The objectives of this study were (1) To identify clinical problems treated in primary, secondary and tertiary level of neonatal health care. Clinical problems were derived from National Guidelines Clearinghouse, the Canadian Pediatric Society, Neonatal Handbook-Victoria (Australia), and the British Association of Perinatal Medicine. (2) To identify medicines currently recommended in WHO and other guidelines for use for each of these clinical problems; (3) To identify clinical evidence to support the use of these medicines. A wide spectrum of sources were searched, including Cochrane Reviews, BNF for Children, The Neonatal Formulary, E-medicine, Database of Abstracts of Reviews of Effects, International Child Health Collaboration, Centers for Disease Control and Prevention, and RxList. (4) To identify prices of each of the selected medicines in the International Drug Price Indicator Guide or British National Formulary for Children 2006 to determine cost-effectiveness. Also, the licensing status of selected medicines was checked.