The WHO Model List of Essential Medicines for Children (aka Essential Medicines List for Children[1] or EMLc[1]), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe in children up to twelve years of age to meet the most important needs in a health system.[2][3]

The list is divided into core items and complementary items.[4] The core items are deemed to be the most cost-effective options for key health problems and are usable with little additional health care resources.[4] The complementary items either require additional infrastructure such as specially trained health care providers or diagnostic equipment or have a lower cost–benefit ratio.[4]

The first list for children was created in 2007, and the list is in its 8th edition as of 2021.[5][4][6]

Note: An α indicates a medicine is only on the complementary list.[4]

Anaesthetics, preoperative medicines and medical gases

General anaesthetics and oxygen

Inhalational medicines

Injectable medicines

Local anaesthetics

Preoperative medication and sedation for short-term procedures

Medical gases

Medicines for pain and palliative care

Non-opioids and non-steroidal anti-inflammatory medicines (NSAIMs)

Opioid analgesics

Medicines for other symptoms common in palliative care

Antiallergics and medicines used in anaphylaxis

Antidotes and other substances used in poisonings

Non-specific

Specific

Anticonvulsants/antiepileptics

Anti-infective medicines

Anthelminthics

Intestinal anthelminthics

A hexagon joined to a polygon with two attachments to this double ringed structure
A skeletal model of the chemical structure of albendazole

Antifilarials

Antischistosomals and other antinematode medicines

Cysticidal medicines

Antibacterials

Access group antibiotics

Watch group antibiotics

Reserve group antibiotics

Reserve antibiotics are last-resort antibiotics. The EML antibiotic book was published in 2022.[7][8][9]

Antileprosy medicines

Antituberculosis medicines

A small pile of white crystals
Pure crystals of ethambutol

Antifungal medicines

Antiviral medicines

Antiherpes medicines

Antiretrovirals

Nucleoside/nucleotide reverse transcriptase inhibitors
Non-nucleoside reverse transcriptase inhibitors
Protease inhibitors
Integrase inhibitors
Fixed-dose combinations of antiretroviral medicines
Medicines for prevention of HIV-related opportunistic infections

Other antivirals

Antihepatitis medicines

Medicines for hepatitis B
Nucleoside/Nucleotide reverse transcriptase inhibitors
Medicines for hepatitis C
Pangenotypic direct-acting antiviral combinations
Non-pangenotypic direct-acting antiviral combinations

No listings in this section.

Other antivirals for hepatitis C

No listings in this section.

Antiprotozoal medicines

Antiamoebic and antigiardiasis medicines

Antileishmaniasis medicines

Antimalarial medicines

For curative treatment
For chemoprevention

Antipneumocystosis and antitoxoplasmosis medicines

Antitrypanosomal medicines

African trypanosomiasis
1st stage
2nd stage
American trypanosomiasis

Medicines for ectoparasitic infections

Antimigraine medicines

For treatment of acute attack

For prophylaxis

Immunomodulators and Antineoplastics

Immunomodulators for non-malignant disease

Antineoplastic and supportive medicines

Cytotoxic medicines

Targeted therapies

Immunomodulators

Hormones and antihormones

Supportive medicines

Medicines affecting the blood

Antianaemia medicines

Medicines affecting coagulation

Other medicines for haemoglobinopathies

Blood products of human origin and plasma substitutes

Blood and blood components

A straw coloured liquid inside a clear plastic bag
Bag containing one unit of fresh frozen plasma

Plasma-derived medicines

Human immunoglobulins

Blood coagulation factors

Plasma substitutes

Cardiovascular medicines

Antianginal medicines

No listings in this section.

Antiarrhythmic medicines

No listings in this section.

Antihypertensive medicines

Medicines used in heart failure

Antithrombotic medicines

No listings in this section.

Lipid-lowering agents

No listings in this section.

Dermatological medicines (topical)

Antifungal medicines

Anti-infective medicines

Anti-inflammatory and antipruritic medicines

Medicines affecting skin differentiation and proliferation

Scabicides and pediculicides

Diagnostic agents

Ophthalmic medicines

Radiocontrast media

Disinfectants and antiseptics

Antiseptics

Disinfectants

Diuretics

Gastrointestinal medicines

Antiulcer medicines

Antiemetic medicines

Anti-inflammatory medicines

No listings in this section.

Laxatives

No listings in this section.

Medicines used in diarrhoea

Oral rehydration

Medicines for diarrhoea

Medicines for endocrine disorders

Adrenal hormones and synthetic substitutes

Androgens

No listings in this section.

Estrogens

No listings in this section.

Progestogens

No listings in this section.

Medicines for diabetes

Insulins

Oral hypoglycaemic agents

Medicines for hypoglycaemia

Thyroid hormones and antithyroid medicines

Immunologicals

Diagnostic agents

Sera and immunoglobulins

Vaccines

Recommendations for all

Recommendations for certain regions

Recommendations for some high-risk populations

Recommendations for immunization programmes with certain characteristics

Muscle relaxants (peripherally-acting) and cholinesterase inhibitors

Ophthalmological preparations

Anti-infective agents

Anti-inflammatory agents

Local anaesthetics

Miotics and antiglaucoma medicines

No listings in this section.

Mydriatics

Anti-vascular endothelial growth factor (VEGF) preparations

No listings in this section.

Medicines for reproductive health and perinatal care

Contraceptives

No listings in this section.

Ovulation inducers

No listings in this section.

Uterotonics

No listings in this section.

Antioxytocics (tocolytics)

No listings in this section.

Other medicines administered to the mother

No listings in this section.

Medicines administered to the neonate

Peritoneal dialysis solution

Medicines for mental and behavioural disorders

Medicines used in psychotic disorders

Medicines used in mood disorders

Medicines used in depressive disorders

Medicines used in bipolar disorders

No listings in this section.

Medicines for anxiety disorders

No listings in this section.

Medicines used for obsessive compulsive disorders

No listings in this section.

Medicines for disorders due to psychoactive substance use

No listings in this section.

Medicines acting on the respiratory tract

Antiasthmatic medicines

Solutions correcting water, electrolyte and acid-base disturbances

Oral

Parenteral

Miscellaneous

Vitamins and minerals

Ear, nose and throat medicines

Medicines for diseases of joints

Medicines used to treat gout

No listings in this section.

Disease-modifying agents used in rheumatoid disorders

Juvenile joint diseases

Dental preparations

Notes

  1. ^ Thiopental may be used as an alternative depending on local availability and cost.
  2. ^ No more than 30% oxygen should be used to initiate resuscitation of neonates less than or equal to 32 weeks of gestation.
  3. ^ Not in children less than three months.
  4. ^ Not recommended for anti‐inflammatory use due to lack of proven benefit to that effect.
  5. ^ Alternatives limited to hydromorphone and oxycodone.
  6. ^ For the management of cancer pain.
  7. ^ a b Alternatives limited to dolasetron, granisetron, palonosetron, and tropisetron
  8. ^ Alternatives limited to cetirizine and fexofenadine
  9. ^ There may be a role for sedating antihistamines for limited indications.
  10. ^ Alternatives limited to prednisone
  11. ^ For use as adjunctive therapy for treatment-resistant partial or generalized seizures.
  12. ^ Alternatives limited to diazepam and midazolam
  13. ^ For buccal administration when solution for oromucosal administration is not available.
  14. ^ The presence of both 25 mg/5 mL and 30 mg/5 mL strengths on the same market would cause confusion in prescribing and dispensing and should be avoided.
  15. ^ a b Avoid use in pregnancy and in women and girls of child-bearing potential, unless alternative treatments are ineffective or not tolerated because of the high risk of birth defects and developmental disorders in children exposed to valproate in the womb.
  16. ^ Oxamniquine is listed for use when praziquantel treatment fails.
  17. ^ > 1 month.
  18. ^ Only for the presumptive treatment of epidemic meningitis in children older than two years and in adults.
  19. ^ Alternatives limited to 4th level ATC chemical subgroup (J01CF Beta-lactamase resistant penicillins)
  20. ^ cloxacillin, dicloxacillin and flucloxacillin are preferred for oral administration due to better bioavailability.
  21. ^ Use in children <8 years only for life-threatening infections when no alternative exists.
  22. ^ Procaine benzylpenicillin is not recommended as first-line treatment for neonatal sepsis except in settings with high neonatal mortality, when given by trained health workers in cases where hospital care is not achievable.
  23. ^ Third-generation cephalosporin of choice for use in hospitalized neonates.
  24. ^ Do not administer with calcium and avoid in infants with hyperbilirubinemia.
  25. ^ > 41 weeks corrected gestational age.
  26. ^ Erythromycin may be an alternative.
  27. ^ Imipenem/cilastatin is an alternative for complicated intraabdominal infections and high-risk febrile neutropenia only, except for acute bacterial meningitis in neonates, where meropenem is preferred
  28. ^ For use only in combination with meropenem.
  29. ^ Terizidone may be an alternative
  30. ^ Prothionamide may be used as an alternative.
  31. ^ For treatment of chronic pulmonary aspergillosis, acute invasive aspergillosis, histoplasmosis, sporotrichosis, paracoccidiodomycosis, mycoses caused by T. marneffei and chromoblastomycosis; and prophylaxis of histoplasmosis and infections caused by T. marneffei in AIDS patients.
  32. ^ For treatment of chronic pulmonary aspergillosis and acute invasive aspergillosis.
  33. ^ Alternatives limited to anidulafungin and caspofungin
  34. ^ for use in second-line regimens in accordance with WHO treatment guidelines
  35. ^ For the treatment of viral haemorrhagic fevers only.
  36. ^ Severe illness due to confirmed or suspected influenza virus infection in critically ill hospitalized patients
  37. ^ For the treatment of cytomegalovirus retinitis (CMVr).
  38. ^ Pangenotypic when used in combination with sofosbuvir
  39. ^ Pangenotypic when used in combination with daclatasvir
  40. ^ Alternatives limited to tinidazole
  41. ^ To be used in combination with artesunate 50 mg.
  42. ^ For use in the management of severe malaria.
  43. ^ Not recommended in the first trimester of pregnancy or in children below 5 kg.
  44. ^ To be used in combination with either amodiaquine, mefloquine or sulfadoxine + pyrimethamine.
  45. ^ Other combinations that deliver the target doses required such as 153 mg or 200 mg (as hydrochloride) with 50 mg artesunate can be alternatives.
  46. ^ For use only for the treatment of Plasmodium vivax infection.
  47. ^ For use only in combination with quinine.
  48. ^ To be used in combination with artesunate 50 mg.
  49. ^ Only for use to achieve radical cure of Plasmodium vivax and Plasmodium ovale infections, given for 14 days.
  50. ^ For use only in the management of severe malaria, and should be used in combination with doxycycline.
  51. ^ Only in combination with artesunate 50 mg.
  52. ^ For use only for the treatment of Plasmodium vivax infection.
  53. ^ For use only in combination with chloroquine.
  54. ^ For the treatment of 1st and 2nd stage of human African trypanosomiasis due to Trypanosoma brucei gambiense infection.
  55. ^ To be used for the treatment of Trypanosoma brucei gambiense infection.
  56. ^ To be used for the treatment of the initial phase of Trypanosoma brucei rhodesiense infection.
  57. ^ To be used for the treatment of Trypanosoma brucei gambiense infection
  58. ^ Only to be used in combination with eflornithine, for the treatment of Trypanosoma brucei gambiense infection.
  59. ^ etanercept and infliximab are alternatives, including quality-assured biosimilars
  60. ^ a b c d e f including quality-assured biosimilars
  61. ^ including quality-assured biosimilars
  62. ^ Alternatives limited to prednisone
  63. ^ Alternatives limited to epoetin alfa, beta and theta, darbepoetin alfa, and their quality-assured biosimilars.
  64. ^ Alternatives are limited to nadroparin, dalteparin, and their quality-assured biosimilars.
  65. ^ Alternatives are limited to the oral form of deferasirox.
  66. ^ Polygeline, injectable solution, 3.5% is considered as equivalent.
  67. ^ Alternatives limited to 4th level ATC chemical subgroup (C09AA ACE inhibitors, plain)
  68. ^ Alternatives limited to 4th level ATC chemical subgroup (D01AC Imidazole and triazole derivatives) excluding combinations
  69. ^ Alternatives limited to 4th level ATC chemical subgroup (D07AC Corticosteroids, potent (group III))
  70. ^ Alternatives limited to calcitriol and tacalcitol
  71. ^ Alternatives limited to podophyllotoxin
  72. ^ Alternatives limited to precipitated sulfur topical ointment
  73. ^ Alternatives limited to atropine and cyclopentolate
  74. ^ Alternatives limited to propanol
  75. ^ Alternatives limited to iodine
  76. ^ Alternatives limited to 4th level ATC chemical subgroup (D08AE Phenol and derivatives)
  77. ^ Alternatives limited to chlorothiazide and chlorthalidone
  78. ^ Alternatives limited to 4th level ATC chemical subgroup (A02BC Proton pump inhibitors) excluding combinations
  79. ^ Alternatives limited to 4th level ATC chemical subgroup (A02BA H2-receptor antagonists) excluding combinations
  80. ^ In acute diarrhoea zinc sulfate should be used as an adjunct to oral rehydration salts
  81. ^ Alternatives limited to insulin detemir, insulin degludec, and insulin glargine, including quality-assured biosimilars
  82. ^ Carbimazole is an alternative depending on local availability.
  83. ^ For use when alternative first-line treatment is not appropriate or available
  84. ^ Exact type to be defined locally.
  85. ^ a b c Recommended for certain regions
  86. ^ a b c d e f Recommended for some high-risk populations
  87. ^ a b c Recommended for immunisation programmes with certain characteristics
  88. ^ Infections due to Chlamydia trachomatis or Neisseria gonorrhoeae.
  89. ^ Alternatives limited to amikacin, kanamycin, netilmicin, and tobramycin
  90. ^ Alternatives limited to 4th level ATC chemical subgroup (S01AE Fluoroquinolones)
  91. ^ Alternatives limited to chlortetracycline and oxytetracycline
  92. ^ Alternatives limited to 4th level ATC chemical subgroup (S01HA Local anaesthetics) excluding cocaine and combinations
  93. ^ Alternatives limited to homatropine hydrobromide or cyclopentolate hydrochloride.
  94. ^ Alternatives limited to indometacin
  95. ^ Alternatives limited to prostaglandin E2
  96. ^ Alternatives limited to beclometasone, ciclesonide, flunisolide, fluticasone, and mometasone
  97. ^ Alternatives limited to terbutaline
  98. ^ Ergocalciferol can be used as an alternative.
  99. ^ Alternatives limited to ofloxacin
  100. ^ For use for rheumatic fever, juvenile arthritis, Kawasaki disease

References

  1. ^ a b "WHO Model Lists of Essential Medicines". World Health Organization. Retrieved 15 April 2021.
  2. ^ "Essential medicines". World Health Organization. Archived from the original on 2 October 2008. Retrieved 20 January 2017.
  3. ^ World Health Organization (2021). The selection and use of essential medicines: report of the WHO Expert Committee on Selection and Use of Essential Medicines, 2021 (including the 22nd WHO model list of essential medicines and the 8th WHO model list of essential medicines for children). Geneva: World Health Organization. hdl:10665/351172. ISBN 9789240041141. WHO technical report series;1035. License: CC BY-NC-SA 3.0 IGO.
  4. ^ a b c d e World Health Organization (2019). World Health Organization model list of essential medicines for children: 7th list 2019. Geneva. hdl:10665/325772. WHO/MVP/EMP/IAU/2019.07. License: CC BY-NC-SA 3.0 IGO.((cite book)): CS1 maint: location missing publisher (link)
  5. ^ World Health Organization (2021). World Health Organization model list of essential medicines for children: 8th list (2021). Geneva: World Health Organization. hdl:10665/345534. WHO/MHP/HPS/EML/2021.03.
  6. ^ World Health Organization (2019). Executive summary: the selection and use of essential medicines 2019: report of the 22nd WHO Expert Committee on the selection and use of essential medicines. Geneva. hdl:10665/325773. WHO/MVP/EMP/IAU/2019.05. License: CC BY-NC-SA 3.0 IGO.((cite book)): CS1 maint: location missing publisher (link)
  7. ^ "The WHO Essential Medicines List Antibiotic Book". World Health Organization (WHO). 24 November 2021. Retrieved 6 October 2022.
  8. ^ The WHO AWaRe (Access, Watch, Reserve) antibiotic book. Geneva: World Health Organization (WHO). 2022. ISBN 978-92-4-006238-2. Retrieved 29 January 2023.
  9. ^ The WHO AWaRe (Access, Watch, Reserve) antibiotic book - Infographics. Geneva: World Health Organization (WHO). 2022. WHO/MHP/HPS/EML/2022.02. Retrieved 29 January 2023.

Further reading

External links

eEML - Electronic Essential Medicines List

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