WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• High percentages of off-label and unlicensed drug use are common in paediatrics.• Data in paediatric oncology patients hardly exist.• Extemporaneously prepared formulations are common. WHAT THIS STUDY ADDS• Off-label and unlicensed use is substantially higher for cytostatic drugs in paediatric as compared with adult oncology.• Comparison with other paediatric reports on drug use cannot be made due to different percentages of diseases in the reports and other rules to dispense medication in the out-patient setting.• There is an urgent need for suitable formulations, licensing of dosages and provision of data on safety and efficacy in children with malignancies. AIMPaediatric drug prescriptions are known for their high percentages of off-label and unlicensed use. In paediatric oncology data available are scarce. The aim of this paper is an analysis of the licensing and labelling status of all prescribed medication over a 2 week period in a Dutch paediatric oncology centre. METHODSAn analysis of the delivery of medication by the hospital pharmacy to patients admitted to the paediatric oncology centre was carried out. RESULTSIn total 268 precriptions were filed for 39 patients. In 87% of children unlicensed medication was used. Fifty-nine per cent of the children received at least two unlicensed drugs. In total 72% of the drugs were used licensed and on-label was found in 57% of the prescriptions. There was a trend that in younger children percentages were lower. International and local guidelines necessitated in many cases unlicensed use, e.g. intrathecal prednisolone, low dose medication such as heparin, ethanol and vancomycin for locking intravenous devices and higher intravenous vancomycin dosages. There were no major differences with respect to type of malignancy. CONCLUSIONOur figures are substantially higher than the figures reported from adult oncology. Comparison with other paediatric reports are cumbersome, due to different percentages of diseases in the reports and other rules to dispense medication in the outpatient setting. Our data are in line with reports mentioning the higher percentages of unlicensed and off-label use. Our data further underpin the need for more research on suitable formulations, dosages, safety and efficacy in these children.

Knowledge of what the infl uence of autism in a parent on the child-parent relationship can be, is important to provide parents and children who require it with suitable support. To add to this knowledge, eight parents with autism were interviewed about their experiences with child rearing and forming a child-parent bond. The results of these interviews will be compared to what is known about the subject from current literature. Finally, the perspective of parents and children on the subject will be integrated.