We received the comment from our Swedish colleagues and have read it with interest [1]. First and foremost, we would like to express our gratitude for heeding our call [2] and appreciation for the time and effort invested in authoring this comment, which inducts the Swedish formulary into our constantly growing list of neonatal formularies.
We hereby explicitly value the reporting on their practices and workflows, as this provides additional transparency on the similarities and dissimilarities in practices between the neonatal formularies. Based on this and former comments, we have generated an updated list of neonatal formularies reported in the initial publication by adding the formularies previously unknown to us (see Table 1) [1,2,3].
It is not surprising that the Swedish National Formulary for Children ePed, which currently provides drug information for the entire pediatric age range, started as a database for drug information for neonates; the unique needs of this population and the scarcity of licensed preparations for neonates are well known and have been described in our original paper [3], the comments that followed [2,4], and elsewhere [5,6].
It was interesting to learn that ePed is not only a “classical” formulary in the sense of a repository of data, which requires the clinician to actively reach for information on a certain drug following a clinical question, but it also serves as a decision support tool that is integrated into the electronic health records (EHR) used in Sweden. Such versatility is expected to increase accessibility to drug information and decrease medication errors, which are common in neonatal inpatient settings and may have dire consequences in this fragile population [7,8,9]. Such an elucidation of uses and implementations of formularies also meet the objective of our original publication, as sharing strategies and methods may provide a pathway to implement similar strategies elsewhere, based on the legal, operational, and regulatory settings in a given country or territory.
We were also impressed by the structured approach towards the expansion and maintenance of the formulary. This two-level process involving the regional ePed committees and the national ePed committee ensures a robust and thorough process for developing reliable drug information. The process of updates to the formulary was also well-described and confers an impression of a “reactive” and up-to-date formulary.
As described before, accessibility to reliable drug information is an absolute necessity for any healthcare professional involved in neonatal care. Government-funding hereby allows formularies to be freely accessible, thus enabling them to serve anyone, which is particularly significant for underfunded medical institutions and developing countries. Therefore, the fact that ePed is government-funded and freely accessible is a great advantage. Another aspect of accessibility is the formulary language; as most encountered formularies are country- or region-specific, it is understandable that they are provided in the local language. Obviously, this will likely preclude professionals from outside the region from using the formulary. We were happy to learn that the translation of ePed to English is being considered and discussed, as this will surely contribute greatly to the neonatal community worldwide.
Finally, we would like to repeat our appreciation and gratitude to all groups and authors for taking the time to describe their formularies for the benefit of the readership of the journal. We hereby repeat our call for international collaboration and invite all formularies around the world to join this effort and share their knowledge and methods for the benefit of neonates anywhere—in the absence of labeled indications and doses for neonates, formularies remain crucial to provide evidence-based guidance to healthcare professionals involved in neonatal pharmacology.
Writing—original draft preparation, D.S.; writing—review and editing, K.A. and A.S. All authors (including the contributors to the Neonatal Drug Formularies Group (T.E.Y, M.C., N.C., L.E., P.S., S.A., T.Z. and S.N.W.) have read and agreed to the published version of the manuscript.
K.A. and T.E.Y. serve as international collaborators in the Australasian Neonatal Medicines Formulary. K.A. and A.S. are members of the multidisciplinary editorial board of the Dutch Pediatric Formulary and its special expert group for neonatology. M.C. serves as Associate Director–Pediatric Neonatal, Clinical Effectiveness, Lexicomp/UpToDate/Facts and Comparison—Span/Emmi. N.C. serves as Deputy Chair of the Paediatric Formulary Committee of the BNF for Children. L.E. serves as Clinical Content Strategy leader for Merative Micromedex. P.S. serves as Editor in Chief for Merative Micromedex. S.A. has, since 2014, received royalties from the sales of neonatal formularies. T.Z. is Managing Director of the Dutch Pediatric Formulary. S.N.W. is Medical Director of the Dutch Pediatric Formulary. S.B. is the Chair of the Australasian Neonatal Medicines Formulary (ANMF) group. D.S. declares no conflicts of interest.
Footnotes
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.
Descriptive characteristics of included neonatal formularies [
# | Name | Publisher | Country | Language | Format | Access | Latest Edition/Year of Printed Publication | URL/ISBN |
---|---|---|---|---|---|---|---|---|
1 | Australasian Neonatal Medicines Formulary (ANMF) | Australasian Neonatal Medicines Formulary (ANMF) consensus group | Australia and New Zealand | English | Digital and print | Public | ||
2 | British National Formulary for Children (BNF for Children) | BMJ, Pharmaceutical Press and RCPCH Publications Ltd. | United Kingdom | English | Digital and print | Public (UK) | 2024–2025 | 9780857114792 |
3 | Dutch/German/Austrian and Norwegian Pediatric Formularies (DPF, also known as “Kinderformularium”) | Foundation Dutch Knowledge Center Pharmacotherapy for Children and | The Netherlands, | Dutch | Digital | Public | ||
4 | Pediatric and Neonatal Lexi-Drugs (Lexicomp) | Wolters Kluwer® | USA | English (online interface is available in 18 languages) | Digital (web-based and mobile application) and print | Subscription | 30th Edition, 2023 | 9781591953913 |
5 | NeoFax | Merative | USA | English | Digital (web-based and mobile application) | Subscription | ||
6 | Neonatal Formulary: Drug Use in Pregnancy and the First Year of Life | Oxford University Press | United Kingdom | English | Digital and print | Full online version requires subscription | 8th Edition, 2020 | 9780198840787 |
7 | Neonatal Dosage and Practical Guidelines Handbook | Saudi Ministry of Health | Saudi Arabia | English | Public | 2nd Edition, 2016 | 9786038144848 | |
8 | SwissPedDose | Swiss Society of Neonatology | Switzerland | German, French, English, Italian | Digital | Public | ||
9 | NeoFarma SIBEN | The Ibero-American Society of Neonatology | The Ibero-American countries | Spanish | Digital | Subscription | 2nd Edition, 2019 | |
10 | The Swedish National Formulary for Children ePed | Astrid Lindgren Children’s Hospital at Karolinska University Hospital | Sweden | Swedish | Digital | Public |
References
1. Garnemark, C.A.; Nydert, P.; Lindemalm, S. The Swedish National Formulary for Children ePed. Comment on Shaniv et al. A Callout for International Collaboration. Reply to Giger, E.V.; Tilen, R. Comment on “Shaniv et al. Neonatal Drug Formularies—A Global Scope. Children 2023, 10, 848”. Children 2023, 10, 1803. Children; 2024; 11, 1339. [DOI: https://dx.doi.org/10.3390/children11111339]
2. Shaniv, D.; Smits, A.; Allegaert, K. on behalf of the Neonatal Drug Formularies Group. A Callout for International Collaboration. Reply to Giger, E.V.; Tilen, R. Comment on “Shaniv et al. Neonatal Drug Formularies—A Global Scope. Children 2023, 10, 848”. Children; 2023; 10, 1803. [DOI: https://dx.doi.org/10.3390/children10111803]
3. Shaniv, D.; Bolisetty, S.; Young, T.E.; Mangum, B.; Ainsworth, S.; Elbers, L.; Schultz, P.; Cucchi, M.; de Wildt, S.N.; van der Zanden, T.M. et al. Neonatal Drug Formularies—A Global Scope. Children; 2023; 10, 848. [DOI: https://dx.doi.org/10.3390/children10050848] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/37238396]
4. Giger, E.V.; Tilen, R. Comment on Shaniv et al. neonatal drug formularies—A global scope. Children 2023, 10, 848. Children; 2023; 10, 1802. [DOI: https://dx.doi.org/10.3390/children10111802]
5. Costa, H.T.M.d.L.; Costa, T.X.; Martins, R.R.; Oliveira, A.G. Use of off-label and unlicensed medicines in neonatal intensive care. PLoS ONE; 2018; 13, e0204427. [DOI: https://dx.doi.org/10.1371/journal.pone.0204427] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/30252920]
6. Allegaert, K. Neonates need tailored drug formulations. World J. Clin. Pediatr.; 2013; 2, pp. 1-5. [DOI: https://dx.doi.org/10.5409/wjcp.v2.i1.1] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25254168]
7. Gray, J.E.; Goldmann, D.A. Medication errors in the neonatal intensive care unit: Special patients, unique issues. Arch. Dis. Child.-Fetal Neonatal Ed.; 2004; 89, pp. F472-F473. [DOI: https://dx.doi.org/10.1136/adc.2003.046060] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/15499131]
8. Santesteban, E.; Arenas, S.; Campino, A. Medication errors in neonatal care: A systematic review of types of errors and effectiveness of preventive strategies. J. Neonatal Nurs.; 2015; 21, pp. 200-208. [DOI: https://dx.doi.org/10.1016/j.jnn.2015.04.002]
9. Eslami, K.; Aletayeb, F.; Aletayeb, S.M.H.; Kouti, L.; Hardani, A.K. Identifying medication errors in neonatal intensive care units: A two-center study. BMC Pediatr.; 2019; 19, 365. [DOI: https://dx.doi.org/10.1186/s12887-019-1748-4] [PubMed: https://www.ncbi.nlm.nih.gov/pubmed/31638939]
You have requested "on-the-fly" machine translation of selected content from our databases. This functionality is provided solely for your convenience and is in no way intended to replace human translation. Show full disclaimer
Neither ProQuest nor its licensors make any representations or warranties with respect to the translations. The translations are automatically generated "AS IS" and "AS AVAILABLE" and are not retained in our systems. PROQUEST AND ITS LICENSORS SPECIFICALLY DISCLAIM ANY AND ALL EXPRESS OR IMPLIED WARRANTIES, INCLUDING WITHOUT LIMITATION, ANY WARRANTIES FOR AVAILABILITY, ACCURACY, TIMELINESS, COMPLETENESS, NON-INFRINGMENT, MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. Your use of the translations is subject to all use restrictions contained in your Electronic Products License Agreement and by using the translation functionality you agree to forgo any and all claims against ProQuest or its licensors for your use of the translation functionality and any output derived there from. Hide full disclaimer
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
Details



1 Pharmacy Services, Kaplan Medical Center (Clalit Health Services), Pasternak St., P.O. Box 1, Rehovot 76100, Israel;
2 Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium;
3 Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium;