To define and evaluate the attention devoted to drug use in children r
ather than just review existing reviews, the present attempt is to see
k out the primary sources of information in the hope that this effort
would not only yield more reliable data, but would also provide an opp
ortunity for reconsidering methodological problems which are possibly
even more important. An English-language literature search for drug us
e in children from 1988 was conducted on two databases and a manual se
arch was made of the literature, with a check of references quoted in
main original articles, reviews and textbooks. The review was then org
anized in two main sections: an overall evaluation of the recent liter
ature concerning drug use in children; the epidemiological profile of
drug exposure as described cumulatively by the drug-utilization studie
s. A substantial lack of systematic attention to this area of drug epi
demiology was found: drug use in the children is a 'hidden' reality in
the literature; the wealth of methodologic developments that have tak
en place in the general field of drug use monitoring has scantly reach
ed children. Children can be considered still ''methodologic orphans''
with respect to the transferable knowledge on the benefit/risk profil
e of therapies they receive. A network has to be developed to monitor
clinical problems, including drug use, as part of an ''audit'' of the
overall management of children.