Off-Label Drug Use in Paediatrics: A World-Wide Problem

Christian      Lenk

Abstract

Since more than 35 years, the international medical scientific community tries to solve the problem of the offlabel use of paediatric drugs. The aim is simple, but ambitious: to supply children and adolescents with effective drugs, as safe as possible, with known and well-documented side effects, and with accurate and up-to-date information on dosage and administration form. However, despite the significant efforts of paediatricians, researchers and international health politics, a number of severe obstacles for the optimal supply of children and adolescents with safe drugs remain. The detailed analysis of the problem shows not only a still remaining lack of medical knowledge, but also persistent weaknesses in the ethical, legal, medical, pharmacological, and political practices that surround the phenomenon of off-label use in paediatrics. The article gives an overview about the remaining difficulties in the field of paediatric off-label medication with special consideration to ethical and regulatory questions.

Keywords: Ethical and legal regulation, off-label use, paediatrics, effective drugs, dosage, children, adolescents, unlicensed drug, Pediatric Rule, quality and safety