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CAMHS won't see you now

Wisdom of GP practice best on contraception

GPs have been urged by the National Patient Safety Agency to audit child prescriptions for inhaled steroids in the wake of the death of a five-year-old girl.

Emma Frame died in 2001 from adrenal suppression from high-dose fluticasone propionate (Flixotide).

A subsequent audit of other patients receiving fluticasone outside of licence in the same hospital found that 34 of 78 children had impaired adrenal function.

Testing of all children receiving fluticasone found 3 per cent had severe impairment of cortisol production and all these were asymptomatic.

Professor David Cousins, head of safe medication practice at the NPSA, said GPs should

double-check steroid use in their child patients.

'It's a very good idea to see if prescriptions are in line with the BNF for children ­ if not is there a good reason?'

In a review of the case, the NPSA said if the BNF for children had been available at the time of the girl's death it would have 'prevented the prescription of high doses of fluticasone going unquestioned'.

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