SPS has a variety of resources on paediatrics which we recommend you check first. For example, our page on using solid oral dosage form antibiotics in children provides advice on administration of antibiotic capsules and tablets for children, including ‘off-label’ crushing tablets and opening capsules when necessary.
For information on vaccines in children, see Vaccines and immunisation: useful resources to support answering questions.
If the information is not available on the SPS website or the information resources listed, or if your clinical scenario is complex, we would suggest you seek further advice from our Medicines Advice Service.
Other primary resources
In addition to our own resources, we particularly recommend the following resources that are free to access:
Local formulary or guidelines
Your local Area Prescribing Committee, Medicines Management Group or similar body may have relevant guidelines or documents on their website. For example, prescribing guidelines and shared care protocols.
Local children’s health services
If your question relates to the care of a specific patient, under the care of a specialist children’s hospital, it can be helpful to contact them directly.
For issues relating to mental health it may be helpful to make contact with your local Children and Young People’s Mental Health Service (CYPMHS, also known as Children and Adolescent Mental Health Services, CAMHS). Contact details should be available on your local Mental Health Trust website.
BNF for Children
The BNF for Children (BNFC) is the standard UK resource for information on the use of medicines in children.
Guidance on prescribing provides useful information including definitions of preterm neonate, neonate, infant, child, etc. There is also advice on managing medicines in schools and advice on excipients.
Drug monographs include licensed and unlicensed doses of medicines – look for an ‘Unlicensed use’ section in the monograph for details. A table showing mean weight and height for children by age and sex can be helpful when checking or calculating doses.
Clinical Knowledge Summaries
The Clinical Knowledge Summaries (CKS) child health speciality has many guidelines relating to child health such as croup, constipation in children, vitamin D deficiency in children. Many other guidelines are also applicable to children, such as asthma and epilepsy.
When using a CKS guideline, click on ‘Have I got the right topic?’ to check what ages the guideline applies to. Some guidelines cover people of all ages from birth to elderly; others are more specific.
CKS topics generally cover diagnosis and management and include prescribing information. They are produced for primary care practitioners.
Summaries of Product Characteristics
SmPCs/SPCs are available via electronic Medicines Compendium and MHRA. They are particularly useful in providing licensed doses and age ranges (sections 4.1 and 4.2), and for information on excipients in liquid formulations (sections 2 and 6.1).
Prescribers need to know the licensed status of medicines they prescribe; using medicines outside of their licensed age ranges is considered ‘off-label’.
Medicines for Children
Medicines for Children provides useful leaflets for patients and carers covering:
- How to give medicines – practical tips for different dosage forms
- Specific medicines – including information on side effects and advice on what to do if the child vomits or a dose is missed
- General medicines advice – such as travelling with medicines and information about unlicensed medicines and off-label use
The website is maintained by the Royal College of Paediatric and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG) and the national children’s charity ‘WellChild’.
The following resources may also be useful and are freely available:
The Neonatal and Paediatric Pharmacists Group (NPPG) website has useful advice for pharmacists and pharmacy technicians with an interest in paediatrics. Of note are position statements on:
- Choosing an oral liquid medicine for children – which includes information on excipients
- Using standardised strengths of unlicensed liquid medicines in children – which lists recommended strengths of 12 medicines
- Alternative oral rehydration solutions during Dioralyte shortages
Paediatric formulary App
The Paediatric Formulary, produced by four London hospitals (previously the Guy’s Children’s Formulary book), is available as an App that can be downloaded for Apple and android devices. Instructions for how to install and navigate the app are available.
Monographs are listed in alphabetical order. Please note that ‘traffic light’ recommendations refer to the South East London Joint Formulary and may not reflect formularies elsewhere.
APPM formulary (palliative care)
The APPM master formulary provides guidance on medicines use in paediatric palliative care. It comprises:
- drug monographs, which include dosage information and key practice points
- appendices, such as morphine equivalent doses, subcutaneous infusion drug compatibility and switching from gabapentin to pregabalin in children with neuropathic pain
If you would like more information on how to approach answering questions on medicines use in children, we recommend:
Medicines Learning Portal
The Medicines Learning Portal is aimed at trainee hospital pharmacists but the content is also relevant to clinical primary care healthcare professionals. The portal includes a tutorial on children which provides advice on:
- questions to ask when considering questions relating to children
- calculating doses
- reducing risk of medication errors in children