O uso off-label de antimicrobianos na pediatria

To investigate, through an integrative review about the off-label use of antimicrobials in pediatrics. The data survey was consolidated by searching the Virtual Health Library (VHL) for articles indexed in the MEDLINE, LILACS and IBECS databases based on the guiding question: “which reasons and contexts lead to the choice of using off-label antimicrobials? within pediatrics? ” For that, the Health Sciences Descriptors (DeCS) were used: Off-Label Use, Anti-Bacterial Agents, Pediatrics in English and Portuguese. As an inclusion, we adopted publications from 2012-2019 cross-sectional, retrospective, observational, comparative studies and review of clinical trials. Incomplete publications were excluded and they escaped the theme. The application of the descriptors led to 18 articles, which after reading the titles, abstracts and applying the exclusion and inclusion criteria were reduced to a final sample of 6 works to be interpreted to extract the most relevant information on the topic. The analysis of the studies showed that most of the drugs prescribed for children and neonates lack labeling on safety, efficacy and dosage for such public. This stems from the difficulty in carrying out children's pharmacological tests, since the rapid physiological changes make it difficult to determine an appropriate dosage and there are still many ethical challenges for conducting the studies. Therefore, with the present study, it was possible to evidence the wide off-label use of antimicrobial drugs within pediatrics, since clinical trials of drugs for this age group are scarce and adaptation for applicability within the hospital environment is necessary.