When do children convert from liquid antiretroviral to solid formulations?
BACKGROUND
Liquid formulations are usually regarded as the gold standard in paediatric formulation; but sometimes, liquid formulations have stability and taste problems as well as being inconvenient for travelling. Therefore, for the management of long-term illness, some older children, parents and clinicians would prefer to use solid formulations. However, there is a lack of studies to investigate the age at which children are converted from liquid to solid formulations.


OBJECTIVE
(1) To investigate the age range at which children convert from liquid antiretroviral drug formulations to solid formulations, the formulations are abacavir, didanosine, lamivudine, stavudine, and zidovudine. (2) To calculate how long children stay on each of five UK liquid formulations (retention time) and factors affecting the retention times of the above liquid formulations.


METHODS
This was a retrospective medical records survey at Great Ormond Street Hospital for Children, London, United Kingdom. Patients' treatment details were entered into SPSS for Windows v. 11.0 and the retention times for the above liquid formulations were calculated i.e., from initiation of the liquid treatment to conversion to solid preparation. The retention times of different preparations were then compared using Cox regression analysis.


RESULTS
A total of 92 patients are included in the analysis. The overall average age at conversion was 7.3 years (95% CI 6.3-8.2). Patients on stavudine were more likely to switch to the corresponding solid dose form than the other four medicines (P < 0.001); more than 50% of patients on stavudine switched to solid formulation after nine months of treatment, however, less than 25% of patients on other formulations switched during the same period.


CONCLUSIONS
Children taking antiretroviral liquid preparations change to solid dose forms at approximately seven years of age. However, for stavudine, children are more likely to take the solid form at an earlier age.
Yeung
Vincent W
VW
Centre for Paediatric Pharmacy Research, The School of Pharmacy, The Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, University of London, 29-39 Brunswick Square, London WC1N 1AX, UK.
Wong
Ian C K
IC
D000367:Age Factors; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D002626:Chemistry, Pharmaceutical; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D016347:Medical Records Systems, Computerized; D019999:Pharmaceutical Solutions; D012044:Regression Analysis; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage; D018119:Stavudine / Q000008:administration & dosage; D013997:Time Factors
D044966:Anti-Retroviral Agents; D019999:Pharmaceutical Solutions; D018894:Reverse Transcriptase Inhibitors; D018119:Stavudine