Document resource
Problem To our knowledge, there is no resource currently available dedicated to providing healthcare professionals guidance on administration of specific medicines in children. This results in a reliance on adult-based references 1 2 which may not be appropriate for paediatric use. There is also a lack of information supporting the manipulation of specific medicines for children. To address these gaps and support clinical decision-making, we initiated the development of in-house individual drug monographs tailored to guiding administration for paediatric patients. This resource aims to provide accurate, practical guidance for the safe and effective administration of medicines in children.We began by reviewing our most frequently used medications and encouraged pharmacists to consult our Medicines Information Unit for guidance on administering specific drugs via enteral feeding tubes. This process enabled us to concentrate our efforts on individual medications, developing tailored monographs in response to real-time enquiries. To ensure pharmacists remain informed, we distribute monthly updates highlighting new monographs and recent updates to existing guidance.Our Paediatric Enteral Administration Resource (The PEAR) provides comprehensive, up-to-date drug monographs specifically designed to support the safe and effective administration of medicines to patients with swallowing difficulties and those requiring their medicines via enteral feeding tubes.Focusing on the more commonly used drugs in Paediatrics, we currently have over 50 monographs, compiled using global resources, literature, stability studies, and both theoretical and practical in-house data. The monographs offer practical advice on drug administration, including local medicine brand and strength availability, absorption data, feed and food interactions, palatability, and Control of Substances Hazardous to Health (COSHH) requirements. Unique features include carbohydrate content for ketogenic and diabetic patients, dissolution bench test images, and International Dysphagia Diet Standardisation Initiative (IDDSI) flow tests on medicine thickness for patients with unsafe swallow. The monographs emphasise best practices for manipulation of solid formulations to minimise dose loss and operator exposure, and guidance to help avoid enteral tube blockage by solid and liquid form medicines.Staff have fed back that the monographs are highly comprehensive and user-friendly. They appreciate having all the relevant information consolidated into a single document, which significantly streamlines the decision-making process by providing a complete overview at a glance. Additional feedback and thorough evaluation are planned to further refine the materials and measure improvement.Conclusions The PEAR has become an essential tool within our Trust, supporting pharmacists and clinicians in making informed clinical decisions, where previous information was lacking, on a daily basis. Its implementation has significantly reduced and improved response times to medication-related enquiries; whereas it once took days or even weeks to gather the necessary information, we can now deliver accurate responses within just a few hours. Whilst our services prioritise the use of licensed medicines and adherence to licensing status, clinical needs occasionally necessitate the manipulation of medicines in an off-label manner, or the requirement to pursue unlicensed alternatives in which there may be limited information on the product in general. The PEAR facilitates these complex decision-making processes, ensuring timely and effective patient care.References NEWT Guidelines [Internet]. [cited 2025 Jul 7]. Available from: https://www.newtguidelines.com/Drug Administration via Enteral Feeding Tubes [Internet]. [cited 2025 Jul 7]. Available from https://www.medicinescomplete.com