Optimising paediatric antiretroviral regimens

Virtually every paediatric first line patient is on a regimen with a nucleoside reverse transcriptase inhibitor (NRTI) backbone consisting of ABC and 3TC (usually together with lopinavir/ritonavir(LPV/r) in younger patients, or with efavirenz (EFV) or dolutegravir (DTG) in older patients. For years our paediatric patients have had to endure two separate syrups, ABC and 3TC. Although these syrups are not terrible in terms of palatability, the children generally don't like them and it is difficult for the caregiver to measure out the correct amount. Also, syrups take up a lot of space both in the pharmacy and in the patient's handbag. For this reason, many countries have switched years ago to dispersible tablets, which are small, well-tolerated and easy to administer, such as the ABC/3TC 120/60 dispersible tablets. They have been used in the rest of Africa for many years, but in South Africa, despite being lodged with what was then MCC around 2015, they were only registered by SAHPRA in 2021.

Prevention and management of malaria during the COVID-19 pandemic

Pharmacists play a critical role in supporting prevention, early recognition and treatment of malaria. In many communities, the pharmacist serves as the primary health practitioner. Considering malaria as an important differential diagnosis in persons requesting medication for fever and influenza-like illness, is a critical component of the consultation process. Eliciting a travel history, or residence in a malaria area, should always prompt referral for malaria testing and further management. Other important pharmacist roles include reviewing prescriptions for antimalarials with respect to dosage schedules, drug interactions and adverse drug reactions. Stock management, especially during the malaria season, and ensuring adequate stocks as part of epidemic preparedness, are key functions. In persons with severe malaria, recognition and provision of artesunate as preferred treatment as per national guidelines, correct mixing of the product, dosing and administration are critical for successful outcome.


Health Professions Council of South Africa


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Pharmacy Focus Issue 8 - 2022