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Topical corticosteroids in infants: prescribing pattern and prescribing errors in Bahrain

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Abstract

Objective

A nationwide, primary care-based prescription audit in infants to determine the prescribing pattern and prescribing errors of topical corticosteroid preparations in Bahrain.

Method

Prescriptions dispensed for infants were collected for two successive weeks from 20 primary-care health centres.

Results

Among 2282 out of 102,084 prescriptions (2.2%) dispensed for infants, 296 (13.0%) had corticosteroids for topical application to the skin, eye and ear. Plain corticosteroids comprised 6.7%, whereas corticosteroids with antiinfectives accounted for 6.3% of topical corticosteroid preparations. Based on potency the proportions of corticosteroids prescribed were: mild (6.7%), moderately potent (2.6%) and potent (3.7%). The frequency of dosing and length of therapy were not stated in 21.6% and 43.6% of prescriptions, respectively. Base cream as a dilutional vehicle was prescribed in 11.2% (11/98) and 32.4% (12/37) prescriptions containing hydrocortisone acetate 1% cream and betamethasone valerate 0.1%, respectively. In few instances two corticosteroids were concomitantly prescribed.

Conclusion

Prescribing moderate-to-potent topical preparations in approximately half of the infants, co-prescription of multiple corticosteroid preparations, omission of important components of prescription, and resorting to the controversial vehicle diluting technique suggest that topical corticosteroid therapy is sub-optimal. In infants, topical corticosteroids should be rationally prescribed. Establishing the treatment guidelines, pharmacovigilance programme and revision of the primary care essential drug list are needed in Bahrain.

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Acknowledgments

We acknowledge the help and assistance given to us by the Ministry of Health, Directorate of Health Centres/Primary Health Care: Dr. Awatif S. Sharaf (Chief of Medical Services for Primary-Care Health Centres); Dr. Bahyia Al Assoomi (Deputy Chief of Medical Services); the pharmacists and the pharmacy technicians of all health centres; Moh’d Ghali Rashid from Medical Library for information retrieval; and Radha Raghavan for her help in manuscript preparation.

Conflicts of interest

None declared.

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Authors and Affiliations

  1. Department of Pharmacology and Therapeutics, Arabian Gulf University, P.O. Box 22979, Manama, Kingdom of Bahrain

    Khalid A. J. Al Khaja & Reginald P. Sequeira

  2. Primary Care, Ministry of Health, Manama, Kingdom of Bahrain

    Awatif H. H. Damanhori & Thuraya M. Al-Ansari

Authors
  1. Khalid A. J. Al Khaja
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  2. Awatif H. H. Damanhori
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  3. Thuraya M. Al-Ansari
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  4. Reginald P. Sequeira
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Corresponding author

Correspondence to Khalid A. J. Al Khaja.

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Al Khaja, K.A.J., Damanhori, A.H.H., Al-Ansari, T.M. et al. Topical corticosteroids in infants: prescribing pattern and prescribing errors in Bahrain. Pharm World Sci 29, 395–399 (2007). https://doi.org/10.1007/s11096-007-9087-1

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  • DOI: https://doi.org/10.1007/s11096-007-9087-1

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