title: Documentation of pediatric drug safety in manufacturers' product monographs: a cross-sectional evaluation of the canadian compendium of pharmaceuticals and specialities.
abstract: OBJECTIVE
  To describe the provision of pediatric drug safety information in a national formulary of manufacturers' drug product monographs.
  
  
  METHODS
  We performed a cross-sectional evaluation of comprehensive product monographs contained in the 2005 Canadian Compendium of Pharmaceuticals and Specialities (CPS). We abstracted data describing indications for prescription, statements about pediatric safety, available preparations, and provision of dosing guidelines. For each monograph we classified pediatric safety data as either present, present but limited or absent. We then described the pediatric safety data in CPS monographs for drugs listed in the published formulary of the Hospital for Sick Children, Toronto, Ontario, Canada.
  
  
  RESULTS
  A total of 2232 product monographs were screened; 684 were excluded and 1548 (66%) were further analyzed. 1462 (94%) had indications that did not exclude children. Pediatric safety information was present in 592 (38%), present but limited in 148 (10%), and absent in 808 (52%) drug monographs. Safety statements were absent in 224 (14%) drug monographs that provided both dosing guidelines and formulations suitable for administration to children, and in 214 (52%) of 411 drugs in the pediatric hospital formulary.
  
  
  CONCLUSIONS
  We evaluated a widely available national source of pediatric prescribing information. Safety data for children was not mentioned in more than half of the product monographs. Moreover, the provision of safety data was discordant with indications for prescription, the availability of pediatric formulations, and dosing guidelines within the monographs, and with inclusion in a pediatric hospital formulary. Our study suggests that the presentation of pediatric safety data in drug product monographs can be improved to better inform prescribing and to optimize pharmacotherapy in children.
authors.affiliation: Department of Critical Care Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Navjeet K
authors.initials: NK
authors.lastname: Uppal
authors.forename: Lee L
authors.initials: LL
authors.lastname: Dupuis
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Parshuram
mesh_terms: D000293:Adolescent; D002170:Canada; D002626:Chemistry, Pharmaceutical; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004282:Documentation; D004345:Drug Industry; D004347:Drug Interactions; D011307:Drug Prescriptions / Q000592:standards; D004358:Drug Therapy / Q000592:standards*; D064420:Drug-Related Side Effects and Adverse Reactions; D005572:Formularies, Hospital as Topic; D017408:Guidelines as Topic; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010372:Pediatrics / Q000592:standards*; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D010599:Pharmacokinetics; D011643:Publishing
chemical_list: D004364:Pharmaceutical Preparations