这些退热药儿童慎用

Core Viewpoint - The recent case of an 11-year-old boy diagnosed with Toxic Epidermal Necrolysis (TEN) after improper medication highlights the urgent need for improved safety in pediatric medication practices [1][2]. Group 1: TEN and Its Risks - TEN is a rare but severe drug-induced skin reaction with a mortality rate ranging from 14.8% to 30% [2]. - Symptoms of TEN progress in stages, starting with fever and fatigue, followed by skin lesions and potential multi-organ involvement [2]. - Children are at higher risk for TEN due to their immature immune systems and skin barriers, with 40% experiencing liver damage and 75% facing eye injuries [2][3]. Group 2: Medication Safety and Guidelines - Medications account for over 90% of TEN cases, with Nimesulide being a common trigger for children, leading to liver damage and immune reactions [3]. - Parents are advised to avoid self-medicating with unclear compound drugs and to use acetaminophen or ibuprofen under specific conditions [3][4]. - The use of certain medications like aspirin and dipyrone is discouraged due to severe side effects, and combination cold medications should be approached with caution [4]. Group 3: Challenges in Pediatric Medication - As of the end of 2023, only 3.2% of marketed drugs are specifically for children, with over 40% of pediatric drug labels lacking dosage information [5]. - There are ongoing issues with the availability of suitable pediatric formulations and the need for more clinical trials [5][6]. Group 4: Policy and Future Directions - The government has initiated policies to encourage the development of pediatric drugs and improve medication management [6][7]. - Local initiatives aim to enhance the quality and availability of children's medications, including prioritizing pediatric formulations in insurance coverage [6][7].