title: Statin use in Australian children: a retrospective audit of four pediatric hospitals.
abstract: OBJECTIVE
  The aim of this study was to perform an audit of the use of statins in Australian pediatric hospitals.
  
  
  METHODS
  A retrospective audit of patients prescribed statins during a visit to a pediatric hospital, as in- or outpatients, was performed in four major children's hospitals in three Australian states. Patients were identified through hospital pharmacy dispensing records. Statin use (dose, type) as well as medical history was recorded.
  
  
  RESULTS
  A total of 157 patients under the age of 18 were included in the audit. The most common reasons for being prescribed a statin included history of organ transplantation, renal disease and familial hypercholesterolemia (FH). Four statins were prescribed: atorvastatin (n = 77), pravastatin (n = 45), simvastatin (n = 25) and rosuvastatin (n = 10). All statins, apart from rosuvastatin, were used in very young children (1-7 years old). Polypharmacy was common in these patients, including combinations with calcineurin inhibitors and diltiazem, which can increase systemic statin exposure. A small number of very young children were prescribed high doses of statin, based on mg/kg dosing.
  
  
  CONCLUSIONS
  Statins were prescribed to children younger than suggested by current Australian guidelines, with atorvastatin being the preferred statin of choice. Long-term safety studies on the use of statins in children have only included FH patients so far, who are generally healthy besides their raised lipid levels. Further long-term safety studies are needed to include the more vulnerable transplant and renal patients, identified in this audit as being prescribed statins. This can help formulate guidelines for the safest possible use of this class of drugs in the pediatric setting, including the possibility of weight-based recommendations for younger children.
authors.affiliation: Faculty of Pharmacy, The University of Sydney, Sydney, NSW, 2006, Australia, ingrid.gelissen@sydney.edu.au.
authors.forename: Ingrid C
authors.initials: IC
authors.lastname: Gelissen
authors.forename: Huy Long
authors.initials: HL
authors.lastname: Nguyen
authors.forename: Darren K
authors.initials: DK
authors.lastname: Tiao
authors.forename: Rita
authors.initials: R
authors.lastname: Ayoub
authors.forename: Parisa
authors.initials: P
authors.lastname: Aslani
authors.forename: Rebekah
authors.initials: R
authors.lastname: Moles
mesh_terms: D000293:Adolescent; D000069059:Atorvastatin; D001315:Australia; D002648:Child; D002675:Child, Preschool; D017723:Drug Utilization Review; D005464:Fluorobenzenes / Q000627:therapeutic use; D006538:Heptanoic Acids / Q000627:therapeutic use; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006938:Hyperlipoproteinemia Type II / Q000188:drug therapy; D007223:Infant; D007674:Kidney Diseases / Q000188:drug therapy; D016377:Organ Transplantation; D017035:Pravastatin / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D011758:Pyrroles / Q000627:therapeutic use; D000068718:Rosuvastatin Calcium; D019821:Simvastatin / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use
chemical_list: D005464:Fluorobenzenes; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D011758:Pyrroles; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; D000069059:Atorvastatin; D019821:Simvastatin; D017035:Pravastatin