http://bmj.com/cgi/content/full/324/7349/0/c
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Three papers in this issue highlight the problem of unlicensed and off-label prescribing in children. Bücheler and colleagues (p 1311) found that 13.2% of prescriptions for a representative group of children in primary care in Germany were off label. Schirm and colleagues (p 1312) found that labelling of drugs prescribed for children was poor: in 21.3% the use in children was not mentioned in the summary, and 19.7% mentioned use in children but without any indication of age. The authors of both papers argue that efforts to improve the quality of pharmacotherapy in children should not exclude widely marketed and firmly established drugs. Although unlicensed and off-label prescribed drugs do not necessarily carry an actual threat to the health of a child, the risk of adverse drug reactions is high as adequate dosing schemes have often not been assessed, report Jong and colleagues (p 1313). This situation is highly unsatisfactory, and efforts should be made to improve it.
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