OBSERVATION OF MEDICINES FOR THE TREATMENT OF DIAPER DERMATITIS ON THE PHARMACEUTICAL MARKET OF UKRAINE

Abstract

Introduction

The neonatal period is the most critical age. There is a high incidence of children in the first year of life on diseases of the skin and subcutaneous tissue. Recently, we can see an increasing proportion of morbidity with atopic dermatitis (10-20%) [1], contact and diaper dermatitis (25%-50%) [5]. Most cases are associated with genetic penchant, an excessive eating of exotic vegetables and fruits, a high frequency of feeding with artificial mixtures etc. [6].

Diaper dermatitis (DD) is an inflammatory reaction of the child`s skin as a result of the mechanical, physical, chemical and microbial factors. It consists of erythema with maceration and may include papules, erosions, and even ulcerations, when severe. The convex surfaces of the newborns buttocks, genitalia, lower abdomen and upper thighs are the places of the greatest affection [3,8]. Disease can occur under conditions of: late diapers changing, mechanical friction, usage of some care products, transition from breastfeeding to artificial feeding, individual sensitivity of the child`s skin, usage of antibiotics [7,8].

Despite the wide variety of drugs that have been successfully used in dermatology, the amount of drugs for the diaper dermatitis treatment is not enough.

So, the aim of our work was to analyze the range of medicines for the treatment of DD, that are presented at the pharmaceutical market ofUkraine.

The object of the study was the information of the State register of drugs ofUkraine, formed by “State expert center of the Ministry of health ofUkraine”.

Methods of research: search, analysis, generalization and systematization of data.

Results and discussion

According to the ATC classification, the range of medicines for the treatment of diaper dermatitis belongs to the group D – dermatological products and consists of several groups: D01 (antifungals for dermatological use), D02 (emollients and protective), D03 (preparations for treatment of wounds and ulcers), D06 (antibiotics and chemotherapeutics for dermatological use) and D07 (corticosteroids, dermatological preparations) [4].

There are 18 drugs, which are used for DD treatment according to the State register of medicines (at 1 December 2016). They are divided into 5 subgroups according to the ATC-classification.  Most of them are D03 group drugs (33,3%) – preparations for treatment of wounds and ulcers (“Panthecrem”,” Happyderm-Zdorovie”, “Panthenol”, “Panteхol Jadran”, “Bepanten”, “Panthenol-Ratiopharm”) and D07 (27,8%) – corticosteroids, dermatological preparations (“Betlieben”, “Hydrocortisone”, “Locoid Crelo”, “Locoid Lipokrem”, “Cutivate”).

Among the components of formulation of the studied drugs the greatest proportion belongs to such active pharmaceutical ingredients as dexpanthenol –  46,7%, zinc oxide – 20,0%, hydrocortisone – 20,0%, clotrimazole – 6,6% and fusidic acid – 6,7%.

Analysis of drugs for the DD treatment, depending on the type of dosage form (DF) showed that drugs are represented by the four DF. The greatest number have the soft dosage forms (ointments – 47,4% and creams – 42,1%).

The assortment of this group of drugs is being shaped by three national and twelve foreign manufacturers. Among Ukrainian manufacturers the lider is Public Joint-Stock Corporation (PJSC) “Fitofarm” (50%), among foreign manufacturers – “Jadran” Galenski Laboratorij d.d., Croatia (14,3%) and Temmler Italia S.r.l., Italy (14,3%).

By legal status 42% of drugs used for the treatment of diaper dermatitis are released from drugstores and their structural units with prescription [2,4].

Conclusions

There were 18 drugs, which are used for treatment of diaper dermatitis according to the State register of medicines (1 December 2016). 95% of them are intended for the treatment of both children and adults and more than 20% of drugs can be used only for children in age 3-6 months. It should also be noted that the nature of the disease is influenced by the individual characteristics of the child, this requires a differentiated approach to the choice of therapy in each case. The creation of an effective pediatric medicines both industrial production and extempore formulation according to the requirements of good manufacturing practice and good pharmacy practice is an actual problem.