title: Acute drug prescribing to children on chronic antiepilepsy therapy and the potential for adverse drug interactions in primary care.
abstract: OBJECTIVE
  To investigate the extent of acute coprescribing in primary care to children on chronic antiepileptic therapy, which could give rise to potentially harmful drug-drug interactions.
  
  
  METHODS
  Acute coprescribing to children on chronic antiepileptic drug therapy in primary care was assessed in 178 324 children aged 0-17 years for the year 1 November 1999 to 31 October 2000. Computerized prescribing data were retrieved from 161 representative general practices in Scotland.
  
  
  METHODS
  One hundred and sixty-one general practices throughout Scotland.
  
  
  RESULTS
  During the study year 723 (0.41%) children chronically prescribed antiepileptic therapy were identified. Fourteen antiepileptic agents were prescribed, with carbamazepine, sodium valproate and lamotrigine accounting for 80% of the total. During the year children on chronic antiepileptic therapy were prescribed 4895 acute coprescriptions for 269 different medicines. The average number of acute coprescriptions for non-epileptic drug therapy were eight, 11, six, and six for the 0-1, 2-4, 5-11, and 12-17-year-olds, respectively. Of these acute coprescriptions 72 (1.5%) prescribed to 22 (3.0%) children were identified as a potential source of clinically serious interactions. The age-adjusted prevalence rates for potentially serious coprescribing were 86, 26, 22, and 33/1000 children chronically prescribed antiepileptic therapy in the 0-1, 2-4, 5-11, and 12-17-year-old age groups, respectively. The drugs most commonly coprescribed which could give rise to such interactions were antacids, erythromycin, ciprofloxacin, theophylline and the low-dose oral contraceptive. For 10 (45.5%0 of the 20 children identified at risk of a potentially clinically serious adverse drug interaction, the acute coprescription was prescribed off label because of age or specific contraindication/warning.
  
  
  CONCLUSIONS
  In primary care, 3.0% of children on chronic antiepileptic therapy are coprescribed therapeutic agents, which could give rise to clinically serious drug-drug interactions.
authors.affiliation: Department of Medicine and Therapeutics, The University of Aberdeen, Foresterhill Health Centre, Foresterhill, Aberdeen AB25 2ZD, UK.
authors.forename: Philipp H
authors.initials: PH
authors.lastname: Novak
authors.forename: Suzie
authors.initials: S
authors.lastname: Ekins-Daukes
authors.forename: Colin R
authors.initials: CR
authors.lastname: Simpson
authors.forename: Robert M
authors.initials: RM
authors.lastname: Milne
authors.forename: Peter
authors.initials: P
authors.lastname: Helms
authors.forename: James S
authors.initials: JS
authors.lastname: McLay
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D004347:Drug Interactions; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004827:Epilepsy / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016347:Medical Records Systems, Computerized; D019338:Polypharmacy; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012606:Scotland
chemical_list: D000927:Anticonvulsants