Prescribing Drugs for Children
Medicines should only be given to children when they are absolutely necessary and after a careful evaluation of the risk–benefit. Most children who attend a dental practice with toothache do not require antibiotics, as in most situations pain can be managed with local measures. Antibiotics should not be prescribed unless there is a good indication that the patient has infection with systemic effects as opposed to pain from pulpitis. Children differ from adults in their response to drugs and doses should always be calculated carefully. Children who are on long-term medication for medical conditions should be given oral health advice, especially those where the medicines contain cariogenic sugars. Wherever possible, medical personnel should be encouraged to use sugar-free options.
Local guidelines should be followed but some important principles of prescription writing are:
- legible writing with indelible ink;
- patient’s age, date of birth and address should be included;
- name of drug clearly written and not abbreviated;
- form, e.g. tablets, suspension etc., should be specified;
- dose, dose frequency and interval should be clearly stated; consider including the dose/kg body weight for pharmacist to double check;
- quantity to be supplied to the patient;
- name and signature of the prescriber.
Calculating Dose for Children
In most authoritative texts on the subject such as the British National Formulary (BNF), doses are standardised according to the body weight. The weight standardised dose is multiplied by the child’s weight. However the dose calculated in this way should not normally exceed the maximum recommended for an adult, so for children who are very overweight, ideal weight and height should be used.