On August 9, the Ho Chi Minh City Department of Health said that the addition of the above drugs has promptly overcome the shortage of drugs at three specialized pediatric hospitals and the Ho Chi Minh City Hospital for Tropical Diseases, which receives children with severe hand, foot and mouth disease, in the context of the epidemic at its peak.

It is known that in recent times, the amount of IVIG in hospitals has been extremely scarce, doctors have to consult and consider carefully, prioritizing the use of the drug for severe cases. If a child with severe hand, foot and mouth disease previously needed two doses according to the regimen, only one dose is used for monitoring and further evaluation, reserving the drug for more severe cases. This is one of the essential drugs, helping to create immunity, effective treatment, reducing the rate of conversion as well as severe complications. This drug has not been produced domestically but must be completely imported from abroad, the global supply has been scarce for the past two years due to the impact of the COVID pandemic.

As for Phenobarbital, this is an important treatment drug included in the treatment regimen for hand, foot and mouth disease issued by the Ministry of Health in Decision No. 1003/QD-BYT dated March 30, 2012. According to this regimen, Phenobarbital can be taken orally or by injection, with injection being preferred when the patient is seriously ill. Phenobarbital is used for children with many advantages and few side effects and has been used by doctors for pediatric patients for a long time.

In hand, foot and mouth disease, Phenobarbital has the role of stopping prolonged seizures and preventing seizure recurrence. In addition, this drug also has a sedative effect, reducing neurological manifestations and startles in children. In addition, when there is cerebral edema (in severe cases), the drug helps reduce cerebral edema and reduce the brain's need for oxygen consumption.

Injectable Phenobarbital takes effect within 5 minutes after injection, peaks in 15-30 minutes and has a relatively short duration of action, only 6 hours. Compared to the oral form, which has a slow onset of action (over 60 minutes), a long duration of action (10-12 hours) and depends on each child's absorption, injectable Phenobarbital is indicated for children with hand, foot and mouth disease in the risk group and severe group.

Oral Phenobarbital can be used for children with mild hand, foot and mouth disease and can be monitored. In hand, foot and mouth disease (or other diseases) where the child has convulsions, the first-line drug is other drugs, not Phenobarbital.

However, difficulties in treatment have arisen when the domestic supply of Phenobarbital has been limited and interrupted for a long time since the end of 2020. In this situation, the professional council of the Ho Chi Minh City Department of Health met and agreed to choose other temporary sedatives to replace the ones currently on the market while waiting to find supplies from other countries as soon as possible.

At the same time, the Ho Chi Minh City Department of Health also sent a dispatch requesting the Drug Administration of Vietnam (Ministry of Health) to support finding drug supply sources and importing companies to meet the treatment needs of Phenobarbital of hospitals. After a long search, on February 1, 2023, Central Pharmaceutical Joint Stock Company CPC1 found a replacement supplier of Phenobarbital and was granted a drug import license by the Drug Administration of Vietnam for 21,000 vials of injectable Phenobarbital.

However, it took a long time to complete the procedures before it could be put into use because Phenobarbital is a psychotropic drug that belongs to the group of drugs that must be specially controlled, so it requires an export license from the competent authority of the exporting country. Therefore, it was not until July 31, 2023 that 21,000 vials of injectable Phenobarbital arrived in Vietnam and were immediately supplied to specialized pediatric hospitals and the Ho Chi Minh City Hospital for Tropical Diseases to serve the treatment of hand, foot and mouth disease, which is at the peak of the epidemic.

According to the Ho Chi Minh City Center for Disease Control, nearly 2,700 cases of hand, foot and mouth disease were recorded last week, 1.4 times higher than the average of last month. The lack of medicine in recent times is also the reason why the city has had to receive and treat many serious cases transferred from other provinces and cities, accounting for about 60-80%.

Meanwhile, the difficulty in treating hand, foot and mouth disease is that it progresses rapidly. Many children with hand, foot and mouth disease are alert and playing, then suddenly startle and quickly develop respiratory failure and stop breathing.

In the context of the EV71 strain being dominant, the health sector predicts that the number of cases and severe cases will continue to increase. This virus strain causes severe illness in infected people, with a higher risk of death than other agents, and has caused major epidemics in 2011 and 2018. The common characteristic of hand, foot and mouth disease caused by this strain is that it usually lasts 4-5 months.