Page 21 of our report:
The Committee also considered extemporaneous preparations involving polypharmacy. The Committee noted that in 1985, WHO defined rational use of medicines as requiring that “patients receive medications appropriate to their needs”. The custom in some places is to treat sick children with a mixture of several medicines (“puyer”), not necessarily all appropriate to their needs. Commonly, adult solid dosage forms are mixed together, ground to a powder, and the powder divided into assumed paediatric doses and then dispensed for administration to the child. Often, some medicines in the mixture are not indicated for the condition being treated. These medicines add to the risk of adverse
events without any possibility of conferring additional benefit. The Committee recommended that as this practice is irrational it should not be used.