Using solid oral dosage form antibiotics in children

9 Dec 2022
Ketan medical writer
Ketan Patel
Medical Writer
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As a parent, it can be difficult to watch your child suffer from an illness or infection. To help ease their discomfort and get them healthy again, antibiotics are often prescribed. Did you know that there are different forms of antibiotic delivery? Using a solid oral dosage form of antibiotics in children is a great way to make sure they get their medication easily and accurately.

Typically, children can begin swallowing tablets around 10 years of age however some children aged as young as 5 or 6 can learn to swallow tablets. Oral liquid drug formulations are often considered to be the most age-appropriate form of drug delivery for paediatric use (newborns to adolescents) since they are developed for younger age groups unable to swallow tablets or capsules and accommodate palatability changes required by children. Children differ from adults in many aspects of pharmacotherapy, including capabilities for drug administration. However, solid oral dosage formulations such as tablets and capsules are increasingly being used for the paediatric population instead of oral suspensions.

One reason is many medications are currently not available in liquid form or may be in short supply. The NHS also has the added benefit of being able to use off-label formulations that come as a solid dose for children – this reduces the requirement for an oral liquid version being dispensed.

What are the advantages of using a solid oral dosage form antibiotic?

Bioavailability

Oral antibiotics are preferred by doctors in many cases because they can provide better bioavailability. Bioavailability is a measure of how much medication reaches the bloodstream, which determines how effective the medication is at treating the infection. Compared to liquid formulations, solid antibiotics often have higher bioavailability and therefore can be more effective at treating infections. Liquid medications can be difficult for some individuals (especially younger children) to absorb because they may not stay in the stomach long enough before being expelled from the body via natural digestion processes. Tablets bypass this issue by allowing for slower absorption rates into the bloodstream, making sure that more medication gets into your child’s system where it can do its job properly.

The excipients in tablets and capsules can alter absorption and therefore improve bioavailability over liquids especially true with certain antibiotics such as amoxicillin. Excipients are ingredients in tablets that help the medication work properly. They can bind, stabilise, and enhance the efficacy of a product or supplement.

Easier to prescribe for healthcare professionals

One of the major benefits of tablets is that their dose is already predetermined and there’s no need for calculating doses like with liquid prescriptions. Tablets can be a better option than liquids for children’s prescriptions, as they are easier and quicker to prescribe. The accuracy of the medication being prescribed is increased, eliminating any human error and reducing the risk of adverse effects from incorrect doses.

Prescribing tablets in larger quantities also streamlines the process for families so that there are fewer trips to the pharmacy. This allows more time for parents and caregivers to spend with their children. Ultimately, tablets offer a safer, simpler, and time-saving alternative when choosing medicinal products for children.

More accurate doses

Another benefit of using tablets is that they offer more accuracy than liquid medications when it comes to measuring out individual doses for paediatric patients. This ensures that your child receives the correct amount of medication every time without any guesswork or variability.

More widely available in pharmacies

For pharmacies, there are also several advantages. This includes a longer shelf-life (as long as two years compared to six months for suspensions), no need for refrigeration, and more availability in local pharmacies compared to suspensions which may not always be stocked due to the shorter shelf-life. Tablets can be a great convenience for pharmacists as they take less time to prepare than liquid formulations

Easier for caregivers

The shelf-life of a liquid dosage form is often much shorter than that of the corresponding solid preparation due to low stability. Tablets have a longer shelf-life, do not require a fridge for storage, are easier to transport and are more readily available in local pharmacies. Some courses of antibiotics last longer than the shelf-life of the liquid preparation, and therefore multiple trips to the pharmacy may be needed to finish a course. This makes it easier for caregivers and parents.

Fewer excipients

There are several concerns regarding the inappropriate excipients used in paediatric formulations. They often contain sweeteners, alcohol, flavourings, and preservatives. Sweeteners help make the medication more palatable and can include sucrose (table sugar), fructose (fruit sugar), dextrose (glucose), and artificial sweeteners such as saccharin, sorbitol, or xylitol. However, sweeteners can produce digestive issues when taken too much.

Alcohol can also be added to help keep the formulation stable over time and some medications may contain up to 10% ethanol (alcohol).

Unpleasant taste masking for active pharmaceutical ingredients can be masked by adding flavour including things like mint, cherry extract, or vanilla flavouring. The taste of a drug which is usually unpleasant is always more prominent when in solution than in a solid form. Flavourings should be checked against existing allergies before being given out.

Preservatives may also be added to help prevent any bacterial growth when stored over time at room temperature. Tablets tend to have a lower number of excipients.

What are the most frequently prescribed antibiotics for children?

The antibiotics most commonly prescribed for children in the UK vary depending on the illness or infection that is being treated. However, the most frequent type of antibiotic prescribed for kids are drugs such as:

  • Amoxicillin
  • Clarithromycin
  • Erythromycin
  • Azithromycin
  • Cefalexin

These antibiotics are approved for use in children by health professionals as they have a low risk of serious side effects. Antibiotics are usually only prescribed if your child has a bacterial infection, as these drugs only work against certain types of bacteria, while they will not be effective against viruses such as the common cold. It’s important to remember that antibiotics should never be taken without a doctor’s orders and they should only be used to treat infections not prevent them.

When it comes to antibiotics for children, dispersing or crushing may be necessary for certain children. This decision is made by a healthcare provider with the child’s best interests in mind. Dispersing or crushing medicine can make it easier for them to swallow and therefore gives them access to the medication they need. It might be helpful to use a strongly flavoured drink (e.g. blackcurrant cordial) or food (e.g. jam, apple sauce, yoghurt) that the child likes to mask the taste of the medicine. Capsule antibiotics can be opened and the granules tipped out and mixed with liquid or soft food.

If a healthcare provider recommends dispersing or crushing antibiotic medications, you can trust that this is being done to ensure your child receives the most benefit out of their treatment plan.

What are the side effects of using antibiotics in children?

The use of antibiotics in children can be beneficial for various infections, however there are some side effects to consider. While generally safe and effective, with any medication there may be possible interactions with other drugs, as well as some potential adverse effects such as abdominal discomfort, nausea and candida overgrowth. It’s important to discuss these risks with your doctor when considering antibiotics and take into account factors like age and weight to ensure safe administrations according to pediatric standards. If you have further questions or concerns regarding the side effects of solid oral dosage form antibiotics in children, a medical professional should be consulted.

What is a problem with the use of antibiotics in children?

Overuse of antibiotics in children is a growing concern. The World Health Organization warns that the continual use of antibiotics can cause bacteria to become resistant. This means that children may not be protected if they fall ill with bacterial infections in the future, due to antibiotics being ineffective, as they were designed to be used only when really needed. It is important to remember that using antibiotics incorrectly, such as for viruses or colds, will not help and only increases the risk of antibiotic resistance for everyone.

Tips for Teaching Your Child To Swallow Pills

Swallowing pills is an important life skill for children to learn. While it may seem like a daunting task, teaching your child how to swallow tablets can be relatively straightforward with some patience and dedication. Acceptability can be high if tablet training is started earlier.

Encourage a positive mindset

The first step in teaching your child how to swallow pills is helping them develop a positive mindset about taking them. Explain why it’s important for them to take their medication as prescribed and relay any experiences you have had with taking tablets or capsules yourself. Hearing stories from loved ones and role models can help children develop a positive attitude towards taking medication.

Start with small tablets

Once your child has developed a good attitude towards taking pills, the next step is getting them comfortable with the sensation of swallowing something large. Start by giving them small tablets such as multivitamins or iron supplements that are easier to swallow than larger capsules and teach them how to take those medications correctly. You can also give them gummy vitamins if they prefer chewable over tablets or capsules. Once they’re comfortable with the smaller tablets, they move on to larger ones such as ibuprofen, paracetamol or allergy medication that come in capsule form.

Practice makes perfect

Make sure that your child has plenty of practice when it comes to taking medication. If they struggle at first, keep trying until they get it right and remind them not to give up! As part of practising, provide regular feedback using words of encouragement such as “Well done!” or “You can do this!” This will help build their confidence and make swallowing pills less intimidating for them over time.

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