Antibiotics are the second most often used medication

subgroup in the investigated sample. In several studies,1 and 4 antibiotics appear in the list of the most common drugs used by children, especially those receiving prescribed medications.8 It is known that the main Dinaciclib order respiratory infections are responsible for a large proportion of outpatient antimicrobial prescriptions, demonstrating the intended use of antibiotics.29 Among the most studied antibiotics, amoxicillin was the most often used by children, and similar to results were found by other researchers.8 Amoxicillin is mentioned in international guidelines as first choice of treatment for the most common childhood infections, such as acute otitis media, sore throats, and sinusitis.1 All medications used for the treatment of children must be submitted to the licensing process to ensure the quality, safety, and efficacy in this age group. The four most commonly used medications in the sample (paracetamol, amoxicillin, ibuprofen, and dipyrone) have good documentation for pediatric use, although their indication is not recommended for some age ranges.8, 26 and 27 Moreover, drugs used for the treatment of respiratory tract diseases show little evidence of efficacy, as mentioned previously. One of the most important factors to be considered

BEZ235 in assessing the available evidence in pediatrics is how to deal with the ethical issues of child protection when performing controlled clinical trials. By definition,

these always involve some degree of risk, which in pediatrics should be assumed by parents, based on potential benefits that will not be immediately available to their own children. Despite the Sclareol benefits that the pharmaceutical industry provides in drug development for adults, it is important to emphasize that economic motivation is not prominent for pediatric use. The reduced drug market for the pediatric age range when compared to other ranges, such as adults and the elderly, in addition to the difficulties inherent to performing clinical trials in children, makes the development of these drugs unattractive to the pharmaceutical industry.30 However, as proposed by Coelho et al., the use of a specific list of essential drugs may be part of a comprehensive policy to stimulate the development and manufacturing of medicines for children in Brazil.9 Some limitations of the present study should be considered. The household survey is subject to biases from interviewers and interviewees, which are not always possible to control. The period in which data collection was conducted, April to July of 2013, coincided with the winter season in the region, when there is increased incidence of viral diseases and respiratory infections, which may have contributed to the higher consumption of certain drug classes, such as analgesics, antipyretics, antibiotics, antitussives, expectorants, mucolytics, and antiasthmatic drugs.