21,000 tubes of medicine to treat hand, foot and mouth disease have arrived in Vietnam.

(Social Affairs) - On July 9th, the Ho Chi Minh City Department of Health announced that 21,000 vials of injectable Phenobarbital have arrived in Vietnam after a long period of interruption, providing a timely supplement to the crucial supply of medication for treating severe hand, foot, and mouth disease in Ho Chi Minh City.

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According to the Ho Chi Minh City Department of Health, in addition to the recent shipment of 1,000 vials of gamma-globulin, 21,000 ampoules of injectable phenobarbital have just arrived in Vietnam after a long interruption, providing a crucial supplement to the treatment of severe hand, foot, and mouth disease at three pediatric hospitals and the Tropical Diseases Hospital in the city, which are currently experiencing a peak in the disease.

Phenobarbital is an important treatment included in the hand, foot, and mouth disease treatment protocol issued by the Ministry of Health in Decision No. 1003/QD-BYT dated March 30, 2012. According to this protocol, phenobarbital can be administered orally or by injection, with the injectable form preferred for severely ill patients.

Phenobarbital is used in children with many advantages and few side effects, and has been a familiar treatment for pediatric patients by doctors for a long time.

In recent weeks, the number of hand, foot, and mouth disease cases has increased rapidly, along with the reappearance of Enterovirus 71 genotype B5,...

In hand, foot, and mouth disease, phenobarbital plays a role in stopping prolonged seizures and preventing seizure recurrence. In addition, phenobarbital has a sedative effect, reducing neurological symptoms and startling in children. Furthermore, in severe cases of cerebral edema, the drug helps reduce brain swelling and decrease the brain's oxygen consumption.

Injectable phenobarbital has a rapid onset of action (5 minutes after injection), a quick peak in effect (15-30 minutes), and a relatively short duration of action (6 hours), compared to the oral form which has a delayed onset of action (> 60 minutes), a longer duration of action (10-12 hours), and depending on individual absorption, injectable phenobarbital is indicated for children with hand, foot, and mouth disease in high-risk and severe groups (group 2b, group 3).

Oral phenobarbital can be used for children with hand, foot, and mouth disease classified as group 2a (mild, monitorable). In cases of hand, foot, and mouth disease (or other illnesses) where children experience seizures, the first-line treatment is a benzodiazepine such as diazepam or midazolam, not phenobarbital.

However, difficulties in treatment arose when the domestic supply of phenobarbital was limited and interrupted for a long period from the end of 2020. In response to this situation, the expert council of the Ho Chi Minh City Department of Health met and agreed to select other sedatives currently available on the market as temporary replacements, such as Diazepam and Midazolam, while waiting for Vietnamese pharmaceutical companies to find alternative sources of supply from other countries as soon as possible.

At the same time, the Department of Health has also sent a letter to the Drug Administration of Vietnam - Ministry of Health requesting support in finding sources of supply and import companies to meet the demand for Phenobarbital treatment in hospitals.

According to a notice from the Drug Administration of Vietnam in công văn (official letter) No. 8498/QLD-KD dated June 22, 2020, regarding the supply of Phenobarbital 100mg/ml, the manufacturer Daihan Pharm Co., Ltd. has ceased production of Danotan. The Administration has requested drug importing companies to contact their foreign partners to find alternative sources of supply.

After a long search, on February 1, 2023, CPC1 Central Pharmaceutical Joint Stock Company found a replacement supplier for phenobarbital and was granted an import license by the Drug Administration of Vietnam for 21,000 vials of Barbit injection 200mg/ml (phenobarbital injection) from the manufacturer Incepta Pharmaceutical Ltd (Bangladesh) to Vietnam.

It took a long time to complete the procedures because Phenobarbital is a psychotropic drug belonging to a group of drugs requiring special control, thus requiring an export license from the competent authority of the exporting country. On July 31, 2023, 21,000 vials of injectable phenobarbital arrived in Vietnam and were immediately supplied by CPC1 Central Pharmaceutical Joint Stock Company to pediatric hospitals and the Ho Chi Minh City Hospital for Tropical Diseases to treat hand, foot, and mouth disease, which was at its peak during the epidemic.

KIM ANH

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