Advances in pediatric pharmacology

Only a minority of the drugs administered to children and infants have a pediatric labeling and have been sufficiently tested for efficacy, safety and correct pediatric dosing, which cannot necessarily be extrapolated from adult data. This situation is scientifically and ethically unacceptable. To address this problem, the suggestion is being made in several countries that more formal legal requirements should be introduced. In the United States, in 1997, a new legislation encouraged pharmaceutical companies to study medicines in children (for example, by offering the financial incentive of a six-month extension to patent exclusivity). However, there are undeniable difficulties in pediatric and neonatal studies. To minimize the risks of clinical investigation in children, appropriate methodologies should be used. New in vitro and in vivo methods are now available, taking into account pediatric characteristics. (C) 2000 Editions scientifiques et medicales Elsevier SAS.