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February 2021
- Vitamin D supplementation for term breastfed infants to prevent vitamin D deficiency and improve bone health
- Magnesium sulphate for treating acute bronchiolitis in children up to two years of age
- Atopic dermatitis in children: when topical steroid treatment “does not work”
- Continuous glucose monitoring for the prevention of morbidity and mortality in preterm infants
- Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth
- Alkindi (hydrocortisone granules): risk of acute adrenal insufficiency in children when switching from hydrocortisone tablet formulations to granules
- Medicines in pregnancy and breastfeeding: new initiative for consistent guidance; report on optimising data for medicines used during pregnancy
- Risk minimisation materials: Pro-Epanutin (fosphenytoin)
- Revised SPC: Tivicay (dolutegravir) 5 mg dispersible tablets
- Large UK study finds children with COVID-19 less likely to report fever, persistent cough or appetite loss
- Botox® (onabotulinumtoxinA) receives US FDA approval for paediatric Detrusor Overactivity associated with a neurologic condition
- Efficacy and safety of tocilizumab for polyarticular‐course juvenile idiopathic arthritis in the open‐label two‐year extension of a phase III trial
- Transforming the care of children and young people (CYP) in London with asthma: Development of the London Asthma Standards
- Association of Intravenous Immunoglobulins Plus Methylprednisolone vs Immunoglobulins Alone With Course of Fever in Multisystem Inflammatory Syndrome in Children
- European CHMP recommends approval of salmeterol / fluticasone (BroPair Spiromax and Seffalair Spiromax) for treatment of asthma
- European CHMP recommends approval of paediatric license extension for pembrolizumab (Keytruda)
- European CHMP recommends approval of paediatric license extension for bedaquiline (Sirturo)
January 2021
- Long-term safety and efficacy of lumacaftor–ivacaftor therapy in children aged 6–11 years with cystic fibrosis homozygous for the F508del-CFTR mutation: a phase 3, open-label, extension study
- The state of children’s mental health services 2020/21
- January BNF/BNF for Children newsletter
- Preservation of fertility in teenagers and young adults treated for haematological malignancies
- Healthcare Safety Investigation Branch (HSIB) launches investigation into weight-based medication errors in children
- Factors influencing the implementation of clinical pharmacy services on paediatric patient care in hospital settings
- Use of tyrosine kinase inhibitors for paediatric Philadelphia chromosome-positive acute lymphoblastic leukaemia: a systematic review and meta-analysis
- PRAC concludes evaluation of risk of acute adrenal insufficiency in children when switching to Alkindi (hydrocortisone) granules
- Dispersible tablet formulation of dolutegravir (Tivicay) in paediatric patients aged at least four weeks and weighing at least 3kg approved in EU
- Valproate use by women and girls
- Use of medicines in pregnancy and breastfeeding
- Immunogenicity of the UK group B meningococcal vaccine (4CMenB) schedule against groups B and C meningococcal strains (Sched3): outcomes of a multicentre, open-label, randomised controlled trial
- Guidance on the hepatitis B antenatal screening and selective neonatal immunisation pathway
- FDA accepts for Priority Review New Drug Application for mirabegron oral suspension and supplemental New Drug Application for Myrbetriq (mirabegron) tablets in paediatric patients with neurogenic detrusor overactivity (NDO)
- Safety of COVID-19 vaccines when given in pregnancy
- Revised SPC: Xyrem (sodium oxybate) 500 mg/ml oral solution
- Review of Cardiac Involvement in Multisystem Inflammatory Syndrome in Children
- DTB select: Can emollient use in early infancy prevent eczema?
- Safety of clonidine used for long‐term sedation in paediatric intensive care: A systematic review
- Revised SPC: Dupixent 200 mg solution for injection in pre-filled pen and syringe
- Biologics During Pregnancy in Women With Inflammatory Bowel Disease and Risk of Infantile Infections: A Systematic Review and Meta-Analysis
December 2020
- European approval of Palforzia for desensitising children and adolescents to peanut allergy
- No population left behind: improving paediatric drug safety using informatics and systems biology
- Erythromycin: update on known risk of infantile hypertrophic pyloric stenosis
- New product: Desizon (zonisamide) 20 mg/ml oral suspension
- Neonatal infection: antibiotics for prevention and treatment
- Neurodevelopmental Outcomes at Age 5 Years After Prophylactic Early High-Dose Recombinant Human Erythropoietin for Neuroprotection in Very Preterm Infants
- Establishing dose‐bands for commonly prescribed oral medications for children in the UK: Results of a Delphi study
- NIHR Alert: Rituximab helps cure almost all children with non-Hodgkin’s lymphoma
- Why breastfeeding is important and how pharmacy can help
- Advising on medicines regimens during breastfeeding
- Pneumococcal conjugate vaccines for preventing acute otitis media in children
November 2020
- New product: Revolade (eltrombopag olamine) oral suspension
- European approval of paediatric license extension of dupilumab (Dupixent) for severe atopic dermatitis
- Revised SPCs: Kalydeco (ivacaftor) granules in sachet – all strengths includes patients aged at least 4 months and weighing >5kg
- Acute otitis media in children
- NIHR Alert: Teenagers’ use of antidepressants is rising with variations across regions and ethnic groups
- European CHMP recommends paediatric license extension and paediatric formulations of dabigatran etexilate (Pradaxa)
- European CHMP recommends paediatric license extension and new strength of rivaroxaban (Xarelto)
- European CHMP recommends paediatric license extension and new formulation of dolutegravir (Tivicay)
- European CHMP recommends license extension sodium oxybate (Xyrem)
- What injections can be given orally or via enteral feeding tubes?
- Probiotics to prevent necrotising enterocolitis in very preterm or very low birth weight infants
- Alternative parenteral acid suppressants covering main indications of intravenous ranitidine in children
- Sapropterin for phenylketonuria (all ages)
- Mercaptamine hydrochloride viscous eyedrops for corneal cystine deposits in people aged older than 2 years
- Prophylactic corticosteroids for paediatric heart surgery with cardiopulmonary bypass
October 2020
- Use of dornase alfa in the paediatric intensive care unit: current literature and a national cross-sectional survey
- Observational study of drug-related problems and clinical pharmacists’ interventions in a French paediatric hospital
- Association of Maternal Prepregnancy Diabetes and Gestational Diabetes Mellitus With Congenital Anomalies of the Newborn
- Palivizumab passive immunisation against respiratory syncytial virus (RSV) in at-risk pre-term infants
- Manufacturers report positive results for dupilumab in Phase III paediatric asthma study
- Is it safe to use visible blue light-emitting diode phototherapy for neonatal jaundice in infants who are also treated with amiodarone?
- Prophylactic anti‐staphylococcal antibiotics for cystic fibrosis
- Can children swallow tablets? Outcome data from a feasibility study to assess the acceptability of different-sized placebo tablets in children (creating acceptable tablets (CAT))
- Positive Phase III data for somatrogon in children (3 to <18 years) with growth hormone deficiency
- FDA grants givinostat Rare Paediatric Disease Designation for Duchenne Muscular Dystrophy
- Intravenous immunoglobulin for presumed viral myocarditis in children and adults
- Corticosteroid therapy for nephrotic syndrome in children
- Giving oral medicines and supplements to children
- Neonatal sepsis
- FDA approves licence extension of golimumab to include paediatric use for active psoriatic arthritis
- Nebulised ALX-0171 for respiratory syncytial virus lower respiratory tract infection in hospitalised children: a double-blind, randomised, placebo-controlled, phase 2b trial
- Beta‐blockers for congestive heart failure in children
September 2020
- Advances in understanding and reducing the burden of severe asthma in children
- Intravenous versus oral antibiotics for eradication of Pseudomonas aeruginosa in cystic fibrosis (TORPEDO-CF): a randomised controlled trial
- Infant respiratory syncytial virus prophylaxis and nasopharyngeal microbiota until 6 years of life: a subanalysis of the MAKI randomised controlled trial
- US FDA approves Xeljanz (tofacitinib) tablets and oral solution for the treatment of active polyarticular course juvenile idiopathic arthritis
- US FDA approves Haegarda – a subcutaneous C1 esterase inhibitor for prevention of hereditary angioedema (HAE) attacks in paediatric patients
- FDA grants setrusumab rare pediatric disease designation for treatment of osteogenesis imperfecta (OI)
- FDA assigns orphan drug and rare pediatric disease designations to SPIRO-2101 for treatment of cystic fibrosis
- Growth concerns in the early weeks of life
- FDA accepts supplemental new drug application for crizotinib for treatment of paediatric ALK-positive anaplastic large cell lymphoma
- Associations Between Prenatal Cannabis Exposure and Childhood Outcomes: Results From the ABCD Study
- Low molecular weight heparin for prevention of central venous catheter‐related thrombosis in children
- Levetiracetam add‐on for drug‐resistant focal epilepsy
- Inhaled mannitol for cystic fibrosis
- Early versus late parenteral nutrition for critically ill term and late preterm infants
- Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children
- Cannabidiol (Epidyolex®) accepted for use within NHS Scotland for Lennox-Gastaut syndrome
- Cannabidiol (Epidyolex®) accepted for use within NHS Scotland for Dravet syndrome
- Vitamin D, calcium or a combination of vitamin D and calcium for the treatment of nutritional rickets in children
- Vaccines for measles, mumps, rubella, and varicella in children
- Association of Selective Serotonin Reuptake Inhibitors With the Risk of Type 2 Diabetes in Children and Adolescents
- Normal saline (0.9% sodium chloride) versus heparin intermittent flushing for the prevention of occlusion in long‐term central venous catheters in infants and children
- FDA to review licence extension for elexacaftor/tezacaftor/ivacaftor and ivacaftor for additional CFTR mutations
- Psychiatric drugs given to children and adolescents have been ranked in order of safety
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Paediatric data for elexacaftor/tezacaftor/ivacaftor in the treatment of cystic fibrosis (CF)
- Vitamin D, calcium or a combination of vitamin D and calcium for the treatment of nutritional rickets in children
- Vaccines for measles, mumps, rubella, and varicella in children
- Clonazepam add‐on therapy for drug‐resistant epilepsy
August 2020
- FDA approves automated insulin delivery and monitoring system for use in children aged 2 to 6 with type 1 diabetes
- Evolocumab in Pediatric Heterozygous Familial Hypercholesterolemia
- Sclerotherapy versus sham or no intervention for primary prophylaxis of oesophageal variceal bleeding in children with chronic liver disease or portal vein thrombosis
- Clinical characteristics of children and young people admitted to hospital with covid-19 in United Kingdom: prospective multicentre observational cohort study
- Introduction of a prescribing ward round to reduce prescribing errors on a paediatric intensive care unit
- Antibiotic treatment for Stenotrophomonas maltophilia in people with cystic fibrosis
- Effect of Vitamin D3 Supplementation on Severe Asthma Exacerbations in Children With Asthma and Low Vitamin D Levels: The VDKA Randomized Clinical Trial
- Improving pain management in childhood acute otitis media in general practice: a cluster randomised controlled trial of a GP-targeted educational intervention
- Enteral lactoferrin supplementation for prevention of sepsis and necrotizing enterocolitis in preterm infants
- Surfactant for pulmonary haemorrhage in neonates
- EU grants marketing authorisation of ivacaftor/tezacaftor/elexacaftor (Kaftrio) for cystic fibrosis
- Ibuprofen for the treatment of patent ductus arteriosus in preterm or low birth weight (or both) infants
- NICE consults on draft quality standard on fetal alcohol spectrum disorder
- Early erythropoiesis‐stimulating agents in preterm or low birth weight infants
- Different unfractionated heparin doses for preventing arterial thrombosis in children undergoing cardiac catheterization
- Evaluation for SARS-CoV-2 in Breast Milk From 18 Infected Women
- Children’s Oncology Group AALL0434: A Phase III Randomized Clinical Trial Testing Nelarabine in Newly Diagnosed T-Cell Acute Lymphoblastic Leukemia
- Air pollution and family related determinants of asthma onset and persistent wheezing in children: nationwide case-control study
- COVID-19 and multisystem inflammatory syndrome in children and adolescents
- Early Access to Medicines Scheme (EAMS) positive scientific opinion: Dupilumab in the treatment of children aged 6 to 11 years of age with severe atopic dermatitis (allergic eczema)
- New-Onset Type 1 Diabetes in Children During COVID-19: Multicenter Regional Findings in the U.K.
- Different infusion durations for preventing platinum‐induced hearing loss in children with cancer
- Anti‐inflammatory medications for obstructive sleep apnoea in children
- Paracetamol (acetaminophen) for prevention or treatment of pain in newborns
- Paracetamol (acetaminophen) for patent ductus arteriosus in preterm or low birth weight infants
- Ibuprofen for the prevention of patent ductus arteriosus in preterm and/or low birth weight infants
- Late erythropoiesis‐stimulating agents to prevent red blood cell transfusion in preterm or low birth weight infants
- Intravenous immunoglobulin for suspected or proven infection in neonatesCochrane update of review 9 studies, n=3,973)
- Intravenous immunoglobulin for preventing infection in preterm and/or low birth weight infantsCochrane review 9 studies (n=5,000)
- FDA approves risdiplam for spinal muscular atrophy in adults and children
- Maternal Use of Specific Antidepressant Medications During Early Pregnancy and the Risk of Selected Birth Defects
- Corticosteroids for treating sepsis in children and adults
- Protecting your child against flu: Information for parents and carers
- Single-Dose Nirsevimab for Prevention of RSV in Preterm Infants
- New product: Treprostinil Tillomed 5 mg/ml and 10 mg/ml solution for infusion
July 2020
- Interventions for idiopathic steroid‐resistant nephrotic syndrome in children
- Reduced Morbidity and Mortality in Survivors of Childhood Acute Lymphoblastic Leukemia: A Report From the Childhood Cancer Survivor Study
- Statins for children with familial hypercholesterolemia
- Neonatal management and outcomes during the COVID-19 pandemic: an observation cohort study
- Medical and surgical interventions for the treatment of urinary stones in children
- Efficacy and safety of oral immunotherapy with AR101 in European children with a peanut allergy (ARTEMIS): a multicentre, double-blind, randomised, placebo-controlled phase 3 trial
- Botulinum toxin type A in the treatment of lower limb spasticity in children with cerebral palsy
- New Product: Hydrocortisone 10mg soluble tablets (Creo Pharma)
- Positive phase III data from post-marketing study of Trikafta (elexacaftor/tezacaftor/ivacaftor and ivacaftor) in people ages 12 and older with cystic fibrosis who have one copy of F508del mutation and one gating or residual function mutation
- Ketoacidosis in Children and Adolescents With Newly Diagnosed Type 1 Diabetes During the COVID-19 Pandemic in Germany
- Chronic Comorbidities Among Survivors of Adolescent and Young Adult Cancer
- Specialist neonatal respiratory care for babies born preterm- quality standard (QS193)
- Methylphenidate and mortality in children with attention-deficit hyperactivity
- Clinical Commissioning Policy: Vedolizumab for refractory ulcerative colitis in pre-pubescent children
- The routine immunisation schedule from June 2020
- European Medicines Agency to host workshop on safe use of medicines during pregnancy and breastfeeding
- U.S. FDA grants Rare Paediatric Disease Designation to silmitasertib for treatment of recurrent sonic hedgehog medulloblastoma
- U.S. FDA grants Orphan Drug Designation to gene therapy for treatment of CLN5 Batten Disease
- Patients with cystic fibrosis to have access to Kaftrio (ivacaftor/tezacaftor/elexacaftor) under deal between NHS and Vertex
- New product: Zolgensma (onasemnogene abeparvovec) 2 x 1013 vector genomes/mL solution for infusion
June 2020
- Multisystem Inflammatory Syndrome in U.S. Children and Adolescents
- Multisystem Inflammatory Syndrome in Children in New York State
- European CHMP recommends approval of caffeine citrate (Gencebok) for treatment of primary apnoea of premature newborns
- Assessment of Acute Acral Lesions in a Case Series of Children and Adolescents During the COVID-19 Pandemic
- Childhood Trust report warns of serious mental health conditions in children due to COVID-19
- Gilead announces plans to study remdesivir in paediatric patients with COVID-19
- Comparative efficacy and acceptability of antidepressants, psychotherapies, and their combination for acute treatment of children and adolescents with depressive disorder: a systematic review and network meta-analysis
- FDA grants approval of dispersible tablet formulation of dolutegravir and extension of paediatric indication for HIV
- COVID-19 – ‘shielding’ guidance for children and young people updated
- Two-year results from ARC004, a follow-on study to phase 3 PALISADE trial of Palforzia (peanut allergen powder) in patients with peanut allergy
- Pfizer announces positive top-line results from JADE TEEN trial of abrocitinib in adolescents with moderate-to-severe atopic dermatitis
- Intravenous fluid therapy in children and young people in hospital- updated guidance (NG29)
- Clinical Characteristics of 58 Children With a Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2
- COVID 19 rapid evidence summary: Remdesivir for treating hospitalised patients with suspected or confirmed COVID-19 (ES27)
- Rituximab for High-Risk, Mature B-Cell Non-Hodgkin’s Lymphoma in Children
- Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study
May 2020
- Acute heart failure in multisystem inflammatory syndrome in children (MIS-C) in the context of global SARS-CoV-2 pandemic
- Hyperinflammatory shock in children during COVID-19 pandemic
- DTB select: Dexamethasone or prednisolone for croup
- COVID-19 Guidance – Paediatric multisystem inflammatory syndrome temporally associated with COVID-19
- European CHMP recommends approval of wider use of ivacaftor in patients with cystic fibrosis and an R117H mutation in the CFTR gene
- European CHMP recommends approval of Harvoni (ledipasvir and sofosbuvir) for the treatment of paediatric patients with chronic hepatitis C
- COVID-19 rapid guideline: children and young people who are immunocompromised – guidance (NG174)
April 2020
- April BNF/BNFc Newsletter
- Protective Effects of Dietary Intake of Antioxidants and Treatment-Related Toxicity in Childhood Leukemia: A Report From the DALLT Cohort
- Mental Health Status Among Children in Home Confinement During the Coronavirus Disease 2019 Outbreak in Hubei Province, China
- JCVI statement on immunisation prioritisation
- Can breastfeeding mothers take paracetamol or paracetamol combination products?
- Revised SPC: Revatio (sildenafil) preparations – risks outweigh benefits in PPH in newborn
- FDA approves selumetinib (Koselugo) for the treatment of children aged from 2 years with neurofibromatosis type 1
- NHS England Speciality Guide: Urgent and emergency musculoskeletal conditions in children (under 16) requiring onward referral
- Impact of Asparaginase Discontinuation on Outcome in Childhood Acute Lymphoblastic Leukemia: A Report From the Children’s Oncology Group
- COVID-19 rapid guideline: cystic fibrosis- guideline (NG170)
- COVID-19 rapid guideline: severe asthma – guidance (NG166)
- National Patient Safety Alert: Interruption of high flow nasal oxygen during transfer
March 2020
- Paediatric to adult transition care for patients with sickle cell disease: a global perspective
- COVID-19: guidance on supporting children and young people’s mental health and wellbeing
- COVID-19 infection in children
- CHMP recommends licence extension for etravirine (Intelence)
- CHMP recommends licence extension for conestat alfa (Ruconest)
- US FDA accepts New Drug Application (NDA) for new formulation of baloxavir for the treatment of influenza in children
- Antibodies in Infants Born to Mothers With COVID-19 Pneumonia
- Possible Vertical Transmission of SARS-CoV-2 From an Infected Mother to Her Newborn
- Decreasing antibiotic use, the gut microbiota, and asthma incidence in children: evidence from population-based and prospective cohort studies
- Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study
- SARS-CoV-2 Infection in Children
- February BNF/BNFC newsletter
- Selumetinib in Children with Inoperable Plexiform Neurofibromas
- Clinical Commissioning Policy: Human coagulation factor X for hereditary factor X deficiency (all ages)
- Clinical Commissioning Policy: Canakinumab for treating periodic fever syndromes: TRAPS, HIDS/MKD and FMF (ages 2 years and older)
- Clinical Commissioning Policy: Dexrazoxane for preventing cardiotoxicity in children and young people (under 25 years) receiving high-dose anthracyclines or related drugs for the treatment of cancer
- Clinical Commissioning Policy: Stereotactic ablative radiotherapy (SABR) for patients with metachronous extracranial oligometastatic cancer (all ages)
- Revised SPC: Dioralyte products
- New product: Adynovi (rurioctocog alfa pegol) 1000 IU powder and solvent for solution for injection 2 ml solvent
- Cardiovascular Health Trajectories From Childhood Through Middle Age and Their Association With Subclinical Atherosclerosis
- Clinical Commissioning Policy: Canakinumab for treating periodic fever syndromes: TRAPS, HIDS/MKD and FMF (ages 2 years and older)
- Clinical Commissioning Policy: Dexrazoxane for preventing cardiotoxicity in children and young people (under 25 years) receiving high-dose anthracyclines or related drugs for the treatment of cancer
- Bronchiolitis: when less is more
- Import restrictions changed for cannabis-based medicines to allow faster access
- Ensuring access to safe, effective, and affordable cannabis‐based medicines
- State of Child Health in the UK
- FDA Grants rare paediatric disease designation for elamipretide for Barth Syndrome
- Efficacy, Safety, and Acceptability of Pharmacologic Treatments for Pediatric Migraine Prophylaxis A Systematic Review and Network Meta-analysis
- Canakinumab for Periodic Fever Syndromes in children to be commissioned by NHS England
February 2020
- Neonatal parenteral nutrition – guidance [NG154]
- Maternal and fetal outcomes following exposure to duloxetine in pregnancy: cohort study
- Skin emollient and early complementary feeding to prevent infant atopic dermatitis (PreventADALL): a factorial, multicentre, cluster-randomised trial
- Daily emollient during infancy for prevention of eczema: the BEEP randomised controlled trial
- Plerixafor (Mozobil®) recommended for use within NHS Wales in combination with G-CSF
- New advances in the treatment of paediatric functional abdominal pain disorders
- Asthma: diagnosis, monitoring and chronic asthma management- updated guideline (NG80)
- Young people’s mental health and wellbeing research
- Refractory Epilepsy Specialist Clinical Advisory Service
- Six-Year Follow-up of a Trial of Antenatal Vitamin D for Asthma Reduction
- A Comparison of Psoriasis Severity in Pediatric Patients Treated With Methotrexate vs Biologic Agents
- Lower versus Traditional Treatment Threshold for Neonatal Hypoglycemia
- US FDA approves Palforzia (Arachis hypogaea) Allergen Powder capsules for treatment of peanut allergy
January 2020
- Committee for Medicinal Products for Human Use (CHMP) issues positive recommendation for license extension of rituximab (MabThera) for paediatric patients
- Update on gender identity development service for children and young people
- First-Trimester Pregnancy Exposure to Modafinil and Risk of Congenital Malformations
- Ondansetron: small increased risk of oral clefts following use in the first 12 weeks of pregnancy
- US FDA approved fidaxomicin oral suspension for clostridioides difficile-associated diarrhoea (CDAD) in children aged six months and older
- Assessing coverage of interventions for reproductive, maternal, newborn, child, and adolescent health and nutrition
- European Medicines Agency approves license extension for ustekinumab to include treatment of plaque psoriasis in children between 6 and 11 years
- Duchenne muscular dystrophy (DMD)
- Vaccination of Infants with Meningococcal Group B Vaccine (4CMenB) in England
- January BNF/BNFC Newsletter
- Where next for inhaled corticosteroids in childhood asthma?
- Effect of Dasatinib vs Imatinib in the Treatment of Pediatric Philadelphia Chromosome–Positive Acute Lymphoblastic Leukemia
- Sodium valproate Pregnancy Prevention Programme – updated Guide for Healthcare Professionals
- A Randomized Trial of Erythropoietin for Neuroprotection in Preterm Infants
- Major cardiac events for adult survivors of childhood cancer diagnosed between 1970 and 1999: report from the Childhood Cancer Survivor Study cohort
- Precocious puberty
- Association Between Fetal Safety Outcomes and Exposure to Local Podophyllotoxin During Pregnancy
- Effect of Treating Parents Colonized With Staphylococcus aureus on Transmission to Neonates in the Intensive Care Unit: A Randomized Clinical Trial
- Antiepileptic Drug Exposure in Infants of Breastfeeding Mothers With Epilepsy
- Lidocaine as treatment for neonatal seizures: Evaluation of previously developed population pharmacokinetic models and dosing regimen
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