O. Olіynyk, І. Kіrda, I. Voitsekhivska
Danylo Halytsky Lviv National Medical University
Introduction. Influenza – an acute infectious disease of viral origin with a short incubation period, sudden onset and cyclical course that is characterized by severe toxicity and defeat of the upper respiratory tract and lungs. During the epidemic from 5.0 to 20.0 % of the population is ill, and particularly high incidence among children. The mortality rate of uncomplicated influenza is 0.01-0.2 %, but it increases sharply in the case of illness in frail persons and young children. The highest incidence occurs in children aged from 1 to 14 years, which is 4 times higher than in older people. At present the urgent problem is to improve the methods of effective prevention and treatment of viral infections in children, including through the use of appropriative dosage forms.
Aim. To identify the main groups of drugs and conduct analysis of the current range of dosage forms that are most often recommended for the prevention and treatment of influenza in children.
Materials and methods. In the process of study were used: the method of content analysis, the bibliographic method and generalization method. The objects of researches were the State Register of medicinal products, The State Form of medicines, clinical protocols and standards of care of influenza and acute respiratory infections.
Results. To ensure the safety of pharmacotherapy in children extremely important is providing and availability of dosage forms of drugs for children. Today there are only 311 drugs in the form of granules, powders, tablets, syrups and suspensions from the total number of medicines, which are approved for children in Ukraine. Formulations for children in Ukraine are represented mostly by foreign manufacturers. The lack of children’s dosage forms of drugs leads to prescriptions medicines for children based on adult dosage forms (eg. tablets divided in half or crushed). It should be noted that in the most developed countries may not use solid dosage forms (tablets, capsules and pills) for children under 3 years.
Results of content analysis of the State Register of medicinal products, clinical protocols and standards of care clarified that for prevention and treatment of influenza and acute respiratory infections in Ukraine are used 191 trade names of drugs in the form of 11 dosage forms. It was found that for prevention and treatment of influenza and acute respiratory viral infections (ARI) in children from the time of birth to 3 months are used 16 (8.38 %) names of drugs, for children aged from 3 months to 1 year are used 15 (7.85 %) names of drugs, for children aged from 1 to 6 years are used 19 (9.95 %) names of drugs, for children aged from 6 to 12 years are used 29 (15.18 %) names of drugs, and for children aged from 12 to 15 years are used 112 (58.64 %) names of drugs.
According to results of the research the main bulk of medicines consist of the tablet dosage form (45.55 %), capsules (6.28 %) and powders (21.99 %), use of which for children aged up to 3 years is problematic. The most effective formulations for children (syrups, suppositories) comprise only 8.37 % of the required range of medicines. The analysis of the seventh issue of the State Form of drugs suggests that for prophylaxis and treatment of viral origin are used those antiviral drugs, belonging to 22 pharmacotherapeutic groups and comprise with about 135 trade names of medicines. Only three groups have the means to prevent and treat of influenza with amount of 9 trade names, and the only three trade names of medicines are produced in Ukraine.
Antiviral drugs for systemic use belong to two classes: cyclic amines (rimantadine) and neuraminidase inhibitors (zanamivir and oseltamivir).
Antiviral drugs of both classes are active against influenza viruses: cyclic amines (rimantadine), are active only against influenza A viruses, while neuraminidase inhibitors (zanamivir and oseltamivir) are active against influenza viruses A and B. On the base of virological surveillance data received during the last flu seasons, most of influenza viruses A (H3N2) are resistant to rimantadine, but sensitive to both neuraminidase inhibitors, and many of influenza viruses A (H1N1) are resistant to oseltamivir, but sensitive to zanamivir and rimantadine.
Analysis of the range of antiviral drugs indicates that only one product – oseltamivir can be used for treatment of influenza in children aged from one to five years. At the same time zanamivir is used for treatment of influenza in children older than 5 years, and rimantadine for treatment of children who are over 7 years.
Conclusions. It was found that the list of regular use of antiviral drugs for prevention and treatment of influenza in children contains only three names. And only one drug – Oseltamivir can be used for treatment of influenza in children aged from one to five years. It was also found that the prevention and treatment of influenza and acute respiratory infections in children are used primarily tablets, capsules and other dosage forms for adults. Increasing efficiency of prevention and treatment of infection diseases in children needs improvement of drug administration methods by increasing the number of appropriate dosage forms.
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