Abstract
Rational and safe use of drugs includes weighing the indication of a drug versus the risk of reactions. 110 instances of drug use were analyzed in 27 neonates with 47 identified drug reactions. Birth weight, gestational age, admission age and length of hospital stay ranged from 835-3570 g, 24-41 wks, 0.5 - 65 days, and 0.5 - 100 days respectively. To assess the accuracy of drug use the degree of indication at initiation of therapy was compared to that at discharge or completion of therapy. 9 degrees (definite, presumptive but highly indicated, resuscitative, prophylactic, procedure-related, empirical, palliative, not indicated, not classified) were based on set clinical, laboratory and pharmacologic criteria. 1/3 of drug use was definitely indicated. Of 21 drugs initially presumed highly indicated, 7 became definitely indicated, but 7 were not indicated, suggesting overtreatment in at least 30% of presumed-indicated drugs. Adverse drug reactions were noted in many drugs not definitely indicated, suggesting that risk may be greater than benefit. Data underscore the need for more careful and rational use of drugs
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