Clinical Study to Determine the Stain Removal Effectiveness of a New Dentifrice Formulation.

OBJECTIVES: This randomized, prospective clinical trial was conducted to determine the safety and effectiveness of a new whitening dentifrice formulation in comparison to that of both a negative and a positive control dentifrice. METHODS: Seventy-nine qualifying subjects were randomly assigned to either the new whitening dentifrice (Arm & Hammer® Truly Radiant™ Clean & Fresh Toothpaste), a positive control whitening dentifrice (Crest® 3-D White® Radiant Mint Toothpaste), or a negative control regular dentifrice (Colgate® Cavity Protection Toothpaste). The subjects brushed with their assigned dentifrice for two minutes, twice daily, for five days. Extrinsic tooth stain was assessed using a Modified Lobene Stain Index (MLSI) at baseline and after five days of product use. RESULTS: All entering subjects completed the study. There were no significant differences (p > 0.05) in stain among the three groups at baseline. The Arm & Hammer Truly Radiant and positive control groups had statistically significant (p < 0.001) mean composite MLSI reduction scores of 13.2% and 7.8%, respectively, from baseline to day five. The negative control dentifrice group was virtually unchanged during this period. Intergroup comparisons showed the Truly Radiant group to have significantly greater stain removal (p < 0.0001) scores than the negative control. The Truly Radiant group also had greater stain removal than the positive control, though the differences were not statistically significant. CONCLUSIONS: This study demonstrates that five-days' use of Arm & Hammer Truly Radiant Clean & Fresh dentifrice was significantly more effective in stain removal than a regular (non-whitening) dentifrice and comparable in effectiveness to a whitening dentifrice positive control.

Clinical Effectiveness Evaluation of a New Whitening Dentifrice.

OBJECTIVE: This randomized controlled clinical trial was conducted to determine the effectiveness and safety of a new whitening dentifrice. METHODS: One hundred eighty-two qualifying subjects were randomly assigned to either a whitening dentifrice group (Arm & Hammer Truly Radiant Toothpaste), a negative control dentifrice group (Colgate Cavity Protection Toothpaste), or a positive control dentifrice group (Crest 3-D White Radiant Mint Toothpaste) and were instructed to brush twice daily with their assigned dentifrice for six weeks. Extrinsic tooth stain was assessed using a Modified Lobene Stain Index (MLSI) and tooth shade was assessed using the VITA Classic Shade Guide at baseline and after five days and two, four, and six weeks of dentifrice use. Safety was monitored by clinical examinations and panelist assessment at each evaluation period. RESULTS: The Arm & Hammer Truly Radiant group showed a statistically significant improvement from baseline in mean composite MLSI and VITA shade at each examination period (p < 0.0001). Significant improvements on day 5 progressively increased with increasing duration of product use. By week 6, there was a 45.4% reduction in stain and a 2.08 improvement in tooth shade. The between-group comparison revealed that Truly Radiant toothpaste was significantly more effective than both the negative and positive control dentifrices for these parameters (p < 0.0001) at each exam time. CONCLUSION: This study showed that the new dentifrice formulation is safe and effective on stain removal and tooth whitening.

Extrinsic Stain Removal Effectiveness of a New Whitening Dentifrice.

OBJECTIVE: This study was conducted to evaluate the effectiveness of Arm & Hammer (A&H) Truly Radiant Rejuvenating toothpaste in removing extrinsic tooth stain compared to that of a conventional fluoride/silica-containing dentifrice. METHODS: This was a randomized, examiner-blind, parallel-design study with two groups of subjects who brushed unsupervised with their assigned dentifrice for two minutes, twice daily, for five days. Extrinsic stain was measured on the labial surfaces of the eight incisor teeth by the Modified Lobene Stain Index (MLSI) at baseline and following five days of product use. After balancing for baseline MLSI, beverage and tobacco use, fifty-four healthy adults with existing stain were randomly distributed into two comparable groups: Arm and Hammer Truly Radiant Rejuvenating toothpaste or Colgate Cavity Protection toothpaste (negative control). Within-treatment comparisons between baseline and day five were made using matched-pair t-tests, and between-treatment comparisons of MSLI scores were performed using ANCOVA, with baseline scores as covariates. RESULTS: Twenty-eight subjects in the Truly Radiant Rejuvenating toothpaste group and twenty-six subjects in the negative control group completed the study. The groups had comparable mean scores at baseline (p > 0.05). The Truly Radiant Rejuvenating toothpaste produced a statistically significant 23.1% total (composite) stain reduction from baseline after five days of product use (p < 0.0001) while the negative control was essentially unchanged (p > 0.05). Between-treatment analysis showed statistically significantly (p < 0.0001) greater stain removal for Truly Radiant Rejuvenating toothpaste compared to the Colgate control following five days of product use. There were no adverse events reported during the study. CONCLUSION: The A&H Truly Radiant Rejuvenating toothpaste is safe and effective in reducing extrinsic stain compared to a regular toothpaste control.

Effectiveness of a new dentifrice with baking soda and peroxide in removing extrinsic stain and whitening teeth.

OBJECTIVE: The primary purpose of this randomized, controlled, six-week clinical trial was to determine the effectiveness and safety of a new whitening dentifrice in removing extrinsic tooth stain and whitening teeth. An additional two-week exploratory study was conducted to determine whether the whitening or stain-prevention activity of the dentifrice would persist following cessation of use. METHODS: In the first study (Phase I), one-hundred and forty-six qualifying subjects were randomly assigned to either a sodium bicarbonate whitening dentifrice group (Arm & Hammer Advance White Extreme Whitening Baking Soda and Peroxide Toothpaste) or a silica-based negative control dentifrice group, and brushed twice daily with their assigned dentifrice for six weeks. Tooth shade on the labial surfaces of the eight incisors was assessed using a Vita Classic shade guide, and extrinsic tooth stain was scored using a Modified Lobene Stain Index (MLSI) at baseline, week 4, and week 6. In Phase II (after the week 6 examination), volunteers from the Arm & Hammer whitening dentifrice group were randomly assigned to continue using the whitening dentifrice or to use the negative control dentifrice twice daily for two weeks. The six-week shade and stain index scores served as the baseline for this exploratory phase and were rescored after two weeks. RESULTS: The whitening dentifrice group had statistically significant (p < 0.0001) mean shade score reductions of 1.82 and 2.57 from baseline to weeks 4 and 6, respectively. For the same periods, the negative control dentifrice group was virtually unchanged from baseline. For tooth stain, the MLSI total mean scores for the whitening dentifrice group showed statistically significant (p < 0.0001) decreases from baseline of 1.42 (41.6%) and 2.11 (61.6%) at weeks 4 and 6, respectively. In contrast, the negative control dentifrice group had a MLSI reduction of 0.07 at week 4 and a 0.06 increase at week 6. Between-group analyses using baseline-adjusted ANCOVA showed the whitening dentifrice to be statistically significantly more effective (p < 0.0001) than the negative control for shade and tooth stain reductions for all index comparisons. Compared to the six-week (baseline) scores, subjects who continued to use the whitening dentifrice for the additional two weeks experienced statistically significant (p < 0.0001) further mean reductions of 0.88 in shade score and 0.46 in MLSI score, while subjects who switched to the negative control dentifrice experienced smaller, statistically significant (p < 0.05) reductions of 0.34 in shade score and 0.13 in total MLSI score. CONCLUSION: The Arm & Hammer whitening dentifrice tested in this study is effective for removing extrinsic tooth stain and whitening teeth. While the results also suggest that this dentifrice may have stain-prevention activity that persists following cessation of product use, such activity would need to be confirmed with further studies.

Comparing the efficacy in providing instant relief of dentin hypersensitivity of a new toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride relative to a benchmark desensitizing toothpaste containing 2% potassium ion and 1450 ppm fluoride, and to a control toothpaste with 1450 ppm fluoride: a three-day clinical study in New Jersey, USA.

OBJECTIVE: The objective of this double-blind, randomized, parallel-design clinical study was to compare the efficacy in reducing dentin hypersensitivity of a novel toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride to a benchmark desensitizing toothpaste containing 2% potassium ion and 1450 ppm fluoride, and to a control toothpaste containing 1450 ppm fluoride, instantly after a single direct topical self-application using a fingertip, and after subsequent brushing twice daily for three days. METHODS: Qualifying subjects from the Piscataway, New Jersey, USA area who presented two hypersensitive teeth with a tactile hypersensitivity score (Yeaple Probe) between 10 and 50 grams of force, and an air blast hypersensitivity score of 2 or 3 (Schiff Sensitivity Scale), participated in this study. The first phase of the study consisted of a single topical application of the assigned product directly onto the hypersensitive surface of each of the two baseline-designated hypersensitive teeth. Study subjects applied a pea-size amount of their assigned toothpaste onto the hypersensitive surface of each tooth and massaged each surface for one minute. The second phase of the study consisted of twice-daily at-home brushing with the assigned toothpaste for three days. Dentin hypersensitivity assessments, as well as examinations of oral hard and soft tissues, were conducted at baseline, immediately after direct topical application, and after three days of product use. RESULTS: One-hundred and twenty-five subjects complied with the study protocol and completed the study. Relative to the benchmark desensitizing toothpaste and the control toothpaste groups, the 8.0% arginine toothpaste group exhibited statistically significant (p < 0.05) reductions in dentin hypersensitivity on both tactile and air blast hypersensitivity scores immediately after direct application. Reductions in sensitivity for the 8.0% arginine toothpaste compared to the benchmark desensitizing toothpaste and control toothpaste were 161.2% and 180.2% (tactile), and 59.8% and 58.0% (air blast), respectively. Relative to the benchmark desensitizing toothpaste and control toothpaste groups, the 8.0% arginine group exhibited statistically significant (p < 0.05) reductions in sensitivity after the subsequent three days of twice-daily regular tooth brushing of 147.1% and 181.2% (tactile), and 70.1% and 70.9% (air blast), respectively. CONCLUSION: A single fingertip topical self-application of a new 8.0% arginine-calcium carbonate toothpaste directly onto the hypersensitive surface of teeth provides significant immediate improvement in dentin hypersensitivity relative to an identical application of a control toothpaste and to a benchmark potassium-based desensitizing toothpaste. Significant improvements in dentin hypersensitivity were also demonstrated after three days of brushing with the 8.0% arginine-calcium carbonate toothpaste, subsequent to the single topical self-application of the product, relative to an identical application of the control toothpaste and to the potassium-based desensitizing toothpaste. The improvement demonstrated by the 8.0% arginine toothpaste after direct application was maintained after three days of twice-daily brushing.

No relationship between vasoactive intestinal polypeptide expression and headache in pituitary tumours.

BACKGROUND: Clinical studies have noted the common presentation of pituitary tumours with significant headache. This has been considered to be one, or a combination of, increased cranial pressure, tumour size with dural stretch, or cavernous sinus invasion. Newer hypotheses suggest an association between the presence of pituitary tumour-associated headaches and the expression and release of nociceptive substances. Vasoactive intestinal polypeptide (VIP), a marker of the cranial parasympathetic system, is increased during acute attacks of some primary headaches, and with its expression in the pituitary may link some pituitary tumours to their headache presentations. METHODS: Using immunohistochemical techniques, VIP expression in pituitary tumour specimens was examined to determine if there was a relationship between the presence or absence of pituitary-associated headache and the expression of VIP immunoreactivity (VIP-IR). A qualitative analysis of the VIP-IR in pituitary cells was performed by observers blinded to the headache status of each patient. The presence of VIP-IR and headache were treated as binary variables and associations tested with chi-square tests. RESULTS: Forty-five per cent of specimens positive for VIP were from patients presenting with headache. There was no statistically significant association between the presence of VIP-IR and headache (chi(2) = 0.077, P = 0.781). CONCLUSION: Although the significance of VIP positivity in pituitary tumour-associated headache is unknown it seems unrelated to headache. It remains possible that the mechanism of these headaches relates to the production of either an as yet unidentified peptide, or a combination of nociceptive peptides.

Comparative seven-day clinical evaluation of two tooth whitening products.

A 1-week study was conducted to compare the tooth whitening efficacy of two carbamide peroxide-based products (one containing 5% carbamide peroxide and one containing 10% carbamide peroxide). In addition, the perception of transient tooth hypersensitivity associated with the use of these products was subjectively evaluated. Sixty participants took part in a double-blind, randomized, parallel clinical study. Change in tooth color was measured by chroma meter and Vita shade guide at the initiation of the study and after 7 days of product use. Color change (delta E) was calculated using the color-difference equation established by the Commission Internationale de L'Eclairage. Data concerning dental hypersensitivity was assessed by subjective panelist questionnaires administered after the day 7 recall examination. Results of the whitening data showed that there was no significant difference between the two products. After 1 week, the mean delta E for the product containing 5% carbamide peroxide was 4.43 +/- 1.89 and the mean delta E for the product containing 10% carbamide peroxide was 4.05 +/- 1.84. However, the subjective data collected on tooth hypersensitivity showed that the product containing 5% carbamide peroxide was associated with less discomfort. Of the group using the 5% carbamide peroxide product, 20% reported transient sensitivity of their teeth after product use for 1 week compared with 53% of the group using the product with 10% carbamide peroxide. Statistical analysis using a 2-tailed t test showed significant differences between the two groups (P < .05). The data suggest that these products are clinically equivalent for tooth whitening; however, the product containing 5% carbamide peroxide was associated with less tooth hypersensitivity after 1 week of application.

Comparative efficacy of the Colgate Actibrush battery-powered toothbrush vs Oral-B CrossAction toothbrush on established plaque and gingivitis: a 6-week clinical study.

The objective of this clinical program was to compare the efficacy of the Colgate Actibrush battery-powered toothbrush and the Oral-B CrossAction Toothbrush (full head, soft bristle) for the control of supragingival plaque and gingivitis. Two independent clinical studies were conducted: Study 1 (repeated 3 times) was a single-use, examiner-blind clinical study designed to measure the removal of plaque after 24 hours of no oral hygiene. Study 2 was a definitive 6-week, examiner-blind clinical study designed to determine plaque and gingivitis efficacy at 3 and 6 weeks. Sixty-one men and women, who had refrained from using oral hygiene procedures for 24 hours, were entered into the study and stratified into 2 balanced groups according to baseline (prebrushing) plaque and gingivitis scores. For Study 1, Modified Navy Plaque Index (Rustogi Refinement) scores were obtained prebrushing and after a 1-minute supervised brushing with the assigned toothbrush and a commercially available toothpaste. On 3 separate occasions, after 24 hours of no oral hygiene, the Colgate Actibrush battery-powered toothbrush removed significantly more plaque than did the CrossAction Toothbrush. For Study 2, subjects were instructed to brush their teeth twice daily for 1 minute with the assigned toothbrush. Plaque Index scores and Löe-Silness Gingival Index scores were assessed after 3 and 6 weeks. At the 6-week examination, the group using the Colgate Actibrush battery-powered toothbrush exhibited a statistically significant reduction in both supragingival plaque and gingivitis, compared with the group that used the CrossAction Toothbrush. The results of these clinical studies support the conclusion that the Colgate Actibrush battery-powered toothbrush is clinically superior for the control of both supragingival plaque and gingivitis, as compared with the Oral-B CrossAction manual toothbrush.

Clearance of sodium lauryl sulphate from the oral cavity.

Sodium lauryl sulphate (SLS) is used in toothpaste and mouth rinses as an emulsifying and surface cleaning agent. SLS has been implicated in an increased incidence of oral irritation in subjects predisposed to recurrent aphthous stomatitis (RAU). Hence, the purpose of this study was to determine the levels of SLS found in the oral cavity following rinsing with an SLS containing mouth rinse and brushing with a SLS containing dentifrice. An analytical method to separate SLS from saliva and other complex systems was developed. The method used high performance liquid chromatography (HPLC) and detection performed using conductivity measurements. Standard curves with known concentrations showed a detection limit of less than 0.4 ug SLS/ml of fluid. 2 clinical studies were conducted to determine the amount of SLS retained in the mouth by a healthy population after rinsing or brushing with commercially available products. The results showed, after rinsing, that 96% of the available SLS from the rinse was recovered in the collected samples within 2 min. Similarly, after brushing, 86% of the SLS contained within the toothpaste was recovered from the collected samples within the first 10 min. These results showed that the amount of SLS retained in the oral cavity was minimal and the contact time between SLS and the oral cavity was very short. A 2nd study was conducted to measure the amount of SLS retained in the mouth by a population susceptible to RAU. After rinsing, 97% of the available SLS was recovered within the first 2 min. Following brushing, 89% of the SLS in the dentifrice was recovered within the first 10 min. These results were comparable to those determined by the study involving the healthy population.

The chemistry and mechanisms of extrinsic and intrinsic discoloration.

The literature on the methods of removing dental stain and whitening teeth is extensive. By comparison, little has been published on the chemical mechanisms that cause dental discolorations. This article proposes a classification for extrinsic dental stain and describes the chemical mechanisms involved in causing tooth discolorations. It also discusses the current theories of the chemistry of stain removal processes.

Intra-oral remineralization of enamel with a MFP/DCPD and MFP/silica dentifrice using surface microhardness.

The present study was undertaken to ascertain the effect of dicalcium phosphate dihydrate (DCPD) abrasive in a dentifrice on the remineralizaton of enamel using a surface microhardness technique. The method of assessing enamel remineralization via surface microhardness (SMH) was validated in a randomized, crossover, double-blind, intra-oral remineralization study conducted with 12 healthy adults. Enamel demineralization was achieved in vitro by covering bovine enamel blocks with exogenous oral bacteria, S. Mutans 1600 Ingbritt, containing glucan which was then exposed to sucrose. In the intra-oral treatment phase, subjects were fitted with oral maxillary palatal retainers, each holding four demineralized enamel blocks. Subjects brushed their teeth for 30 seconds with a test dentifrice, swished for an additional 60 seconds, rinsed with water and then retained the blocks intra-orally for 4 hours. Percent mineral recovery for each enamel block was calculated as the ratio of the changes in enamel microhardness due to treatment (remin) and sucrose challenge (demin). Treatments included DCPD-based dentifrices containing 0, 250 and 1000 ppm fluoride (F) from sodium monofluorophosphate (MFP). Using SMH, respective mean percent mineral recoveries of 5.7, 18.7 and 41.4% were obtained. All ADA criteria for model validation were fulfilled. This same model was then used to compare the remineralization effects of a silica placebo, DCPD placebo, 1000 ppm F MFP/silica and 1000 ppm F MFP/DCPD dentifrice. Mean percent mineral recoveries of -0.9, 24.1, 30.2 and 55.7% were obtained, respectively. The MFP/DCPD dentifrice was superior to MFP/silica (<0.01) with use of the MFP/DCPD dentifrice when compared to MFP/silica or the silica placebo. These results indicate that more active calcium and a higher degree of saturation (DS(EN)) with respect to enamel exists for an extended period of time after use of a MFP/DCPD dentifrice. Since an elevation in DS(EN) is considered a major parameter controlling the extent of enamel remineralization, this finding may partly explain the superior remineralization of enamel observed with the MFP/DCPD dentifrice. The significant increases in calcium activity and intra-oral enamel remineralization by the DCPD-based dentifrice are consistent with earlier findings that a DCPD abrasive provides added benefit for enamel remineralization.

Engineering and production of streptokinase in a Bacillus subtilis expression-secretion system.

Streptokinase is one of the major blood-clot-dissolving agents used in many medical treatments. With the cloned streptokinase gene (skc) available, production of the secreted streptokinase from various Bacillus subtilis strains was studied. The use of the six-extracellular-protease-deficient strain, WB600, greatly improved the production yield of the secreted streptokinase. A modified skc which has the original skc promoter and signal sequence replaced with the B. subtilis levansucrase promoter and signal sequence was also constructed. B. subtilis carrying either the wild-type or the modified skc produces streptokinase at a comparable level. Even with WB600 as the expression host, a C-terminally-processed streptokinase was also observed. Through region-specific combinatorial mutagenesis around the C-terminal processing sites, streptokinase derivatives resistant to C-terminal degradation were engineered. One of the derivatives showed a 2.5-fold increase in specific activity and would potentially be a better thrombolytic agent.

Effects of Colgate Platinum Professional Toothwhitening System on microhardness of enamel, dentin, and composite resins.

The purpose of this study was to evaluate the effect of Colgate Platinum Professional Toothwhitening System on the microhardness of enamel, dentin, and two composite resins. This in vitro study replicated conditions in the oral cavity and followed the prescribed procedure for whitening teeth. The results of this study showed no significant differences in the microhardness of the control and treated teeth or the composite restorations tested. This indicates that the use of Colgate Platinum will not soften teeth or the composite restoratives studied.

Comparative clinical evaluation of two professional tooth-whitening products.

A 2-week study was conducted to compare the tooth-whitening efficacy of two 10% carbamide peroxide products: Colgate Platinum Professional Toothwhitening System and Rembrandt Lighten Bleaching Gel. Fifty subjects were divided into two groups and assigned a product to use for 2 weeks. Change in tooth color was measured by reflectance spectroscopy at the initiation of study, at 1 week, and at 2 weeks into the study. Color change was calculated using the color-difference equation established by the Commission International de L'Eclairage. Results showed that Colgate Platinum was 62% more effective at tooth whitening after 1 week and 83% more effective after 2 weeks of treatment vs Rembrandt. At the termination of the study, the mean color difference (deltaE) for Colgate Platinum was 4.29 and 2.34 for Rembrandt. Statistical analysis demonstrated that the Colgate product is significantly superior at increasing tooth whiteness, increasing tooth lightness, reducing redness, and reducing yellowness. In this study, no adverse reactions were noted on clinical examination and none were reported by panelists with normal healthy dentition.

Clinical comparison of Colgate Platinum Toothwhitening System and Rembrandt Gel Plus.

A 2-week, three-cell study was conducted to evaluate the tooth-whitening efficacy of the Colgate Platinum Professional Toothwhitening System vs Rembrandt Gel Plus (a regimen of products consisting of a 10% carbamide peroxide gel, a whitening toothpaste, and a mouthrinse), and a placebo paste. Seventy subjects completed this parallel, single-blind, three-compartment, randomized clinical study. The subjects were balanced into two groups based on a minimal shade of A3 on the Vita shade guide and assigned a product. The duration of product usage was 1 hour twice daily for 2 weeks. Change in tooth color was measured by reflectance spectroscopy using a colorimeter. The readings were taken in the L*, a*, b* color space at the initiation, at 1 week, and at 2 weeks of the study. Calculation of color change (delta E) was performed using the color difference equation established by the Commission Internationale de L'Eclairage. Visual evaluation of shade changes was performed using the Vita shade guide. Results from this clinical study showed that Colgate Platinum was 77.7% more effective at tooth whitening after 1 week and 41.8% more effective after 2 weeks of treatment vs the Rembrandt regimen. Results showed that the Colgate product is significantly superior vs Rembrandt at increasing tooth whiteness (increase in delta E). Shade guide changes showed an overall improvement of 7.08 Vita tabs for the Colgate product and 5.12 Vita tabs for the Rembrandt regimen.

Clinical evaluation of Colgate Platinum Professional Toothwhitening System and Rembrandt Lighten Bleaching Gel.

A 2-week study was conducted to evaluate the tooth-whitening efficacy of Colgate Platinum Professional Toothwhitening System vs Rembrandt Lighten Bleaching Gel. Thirty-eight subjects completed this single-blind, randomized, parallel clinical study. The subjects were balanced into two groups based on a minimal shade of A3 on the Vita shade guide. The duration of product use was 30 minutes, twice daily for 2 weeks. Change in toodth color was measured by reflectance spectroscopy using a colorimeter. The readings were taken in the L*, a*, and b* color space at the initiation of the study, at 1 week, and at 2 weeks. Calculation of color change (deltaE) was performed using the color difference equation established by the Commission International de L'Eclairage. Results demonstated that Colgate Platinum was 46% more effective at tooth whitening after 1 week, and 96% more effective after 2 weeks of treatment. The results demonstrated that the Colgate product was significantly superior vs Rembrandt at increasing tooth whiteness (increase in deltaE), and tooth lightness (increase in deltaL*). No adverse reations were noted on clinical examination.

Diagnoses and prescribing for pediatric patients at two hospitals in Harare, Zimbabwe.

PIP: During March-August 1990 in Zimbabwe, researchers reviewed the medical records of 500 consecutive patients, 0-12 years old, at Harare Hospital and Parirenyatwa Hospital to lean what the most frequent pediatric diagnoses were and to compare prescribing patterns. These hospitals were of comparable size but served different populations. Patients at Harare Hospital tended to have a lower income and be children than those at Parirenyatwa Hospital. Parirenyatwa Hospital specialized in cardiovascular, hematology, medicine, and oncology services. Clinicians identified 737 diagnoses. The most common diagnoses included respiratory infections (39.4% of patients), gastroenteritis (16.8%), malnutrition (10.4%), sepsis (9.6%), and AIDS (8.6%). 97.8% of the children received at least 1 medication (1725 prescriptions). The mean drugs prescribed per patient stood at 3.45 (range, 0-18). Patients with AIDS accounted for the high end of the range. The most frequently prescribed drug type was antibiotics (about 35%), especially penicillin. The recommended duration of antibiotic treatment is 7-14 days, but the mean duration among these children was only 5.1 days. Harare Hospital had more patients admitted for infections and neurologic conditions than did Parirenyatwa Hospital (47.1% vs. 35.% and 4.5% vs. 2%, respectively), which accounted for the higher prescription rate for anti-infective drugs and central nervous system drugs at Harare Hospital (55.4% vs. 47.3%, and 3.5% vs. 2.6%, respectively). Parirenyatwa Hospital had more surgical procedures and febrile convulsions than Harare Hospital, which explained why it had higher prescription rate for analgesics (12.5% vs. 8.7%). It also had more children diagnoses with respiratory infections. Harare Hospital had more malnutrition, sepsis, and AIDS pediatric cases. Since the two hospitals served different socioeconomic populations, it was not surprising to find differences in prescription patterns, which were appropriate and tended to abide by the Essential Drugs List recommendations.^ieng

Drug prescribing in paediatric in-patients at Harare and Parirenyatwa Central Hospitals.

Two-hundred-and-fifty records were examined at Harare and 250 at Parirenyatwa Central Hospitals over a six-month period to investigate drug prescribing patterns for paediatric in-patients. The majority of the patients were between one to three years and weight 6 to 7.9 kg. A total of 1,725 prescriptions were received by these patients with an average of 3.45 (range = 0-18 drugs) per patient. The most frequently used pharmacological groups at both hospitals were anti-infectives (51 pc), intravenous fluids and supplements (22 pc) and analgesics (10.6 pc). Benzylpenicillin accounted for 14.6 pc at Harare and 12.9 pc at Parirenyatwa hospital of the anti-infectives respectively. Infections (49 pc) and gastro-enteritis (11.5 pc) were the main diagnoses in all age groups at both hospitals. Respiratory tract infections accounted for 13.5 pc at Harare and 15.2 pc at Parirenyatwa hospital respectively. There was a rational correlation between prevalent diagnosis and drugs used.