gms | German Medical Science

Background: Polypharmacy is a well-known phenomenon especially in the elderly population and has been studied extensively in recent years. Previous anecdotal evidence also showed, however, a peek of apparent polypharmacy in young children. Published material on drug-related problems ín the young mostly focuses on ADRs in general, but not on potential drug-drug interactions.

Materials and Methods: AOK prescription data for the 3rd quarter 2014 are analysed for polypharmacy in children, especially for the under-5s. Since for children, drugs available without prescription are reimbursable, it can be assumed that most drugs will in fact be prescribed and, hence, included in the data. We employ the definition of cumulative polypharmacy, here defined as having received prescriptions from 5 or more ATC codes within the period studied.

Results: The proportion of children under 5 having received 5 or more different substances is substantial. This proportion drops off quickly for older children. Contrary to the patterns seen in the elderly, use of 8 or more substances is not widespread. The substances most frequently involved in polypharmacy are those also found otherwise in young children. Antibiotics, both systemic and topic, are major contributors to polypharmacy over "baseline" treatment.

Conclusion: Polypharmacy in young children is mostly caused by short-term therapeutical needs over and above treatment for common chidlren's diseases. Since the duration is short, potential negative effects can be assumed to be limited. While polypharmacy is a quality issue in the elderly, there appears to be little need for action in children. Apart from issues of polypharmacy, however, the absolute level of use of some drugs, like e.g. xylometazoline, may be questioned.