Non-antibiotic medication use in an Indonesian community cohort 0-18 months of age

PLoS One. 2020 Nov 18;15(11):e0242410. doi: 10.1371/journal.pone.0242410. eCollection 2020.

Abstract

Background: Rational medication use for treatment is mandatory, particularly in children as they are vulnerable to possible hazards of drugs. Understanding the medication use pattern is of importance to identify the problems of drug therapy and to improve the appropriate use of medication among this population.

Methods: A post-hoc study of the RV3-BB Phase IIb trial to children aged 0-18 months which was conducted in Indonesia during January 2013 to July 2016. Any concomitant medication use and health events among 1621 trial participants during the 18 months of follow-up were documented. Information on medication use included the frequency, formulation, indication, duration of usage, number of regimens, medication types, and therapeutic classes.

Results: The majority of participants (N = 1333/1621; 82.2%) used at least one non-antibiotic medication for treatment during the 18-month observation period. A total of 7586 medication uses were recorded, mostly in oral formulation (90.5%). Of all illnesses recorded, 24.7% were treated with a single drug regimen of non-antibiotic medication. The most common therapeutic classes used were analgesics/antipyretics (30.1%), antihistamines for systemic use (17.4%), cough and cold preparations (13.5%), vitamins (8.6%), and antidiarrheals (6.6%). The main medication types used were paracetamol (29.9%), chlorpheniramine (16.8%), guaifenesin (8.9%), zinc (4.6%), and ambroxol (4.1%). Respiratory system disorder was the most common reason for medication use (51.9%), followed by gastrointestinal disorders (19.2%), pyrexia (16.9%), and skin disorders (7.0%).

Conclusion: A large number of children were exposed to at least one medication during their early life, including those where evidence of efficacy and safety in a pediatric population is lacking. This supports the need for further research on pediatric drug therapy to improve the appropriate use of medication in this population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics
  • Antipyretics
  • Drug Therapy / statistics & numerical data
  • Drug Therapy / trends*
  • Drug Utilization / statistics & numerical data*
  • Drug Utilization / trends*
  • Drug Utilization Review / methods
  • Female
  • Histamine Antagonists
  • Humans
  • Indonesia / epidemiology
  • Infant
  • Infant, Newborn
  • Male
  • Pharmaceutical Preparations

Substances

  • Analgesics
  • Antipyretics
  • Histamine Antagonists
  • Pharmaceutical Preparations

Grants and funding

The vaccine company PT Bio Farma provided support for this study in the form of a salary for the author NSB. The specific role of this author is articulated in the ‘author contributions’ section. Additionally, PT Biofarma was one of the funders of the RV3-BB Phase IIb trial. Another funding source of the RV3-BB Phase IIb trial was Murdoch Children’s Research Institute. The funders had roles in the study design, decision to publish, and preparation of the manuscript.