Abstract
BackgroundNeonatal populations are quite susceptible to drug-related problems (DRPs) because of clinical heterogeneity and clinical practice trends. However, studies reporting DRPs in the neonatal population are quite limited.ObjectiveThis study aimed to assess the magnitude and types of DRPs and determinant factors among neonates admitted with neonatal sepsis at the Neonatal Intensive Care Unit (NICU) of the Jimma University Medical Center (JUMC), Ethiopia.MethodsA hospital-based prospective observational study was conducted involving 201 neonates with sepsis admitted to the NICU from May to August 30, 2018. DRPs were classified using Cipolle’s classification method. Statistical Package for Social Science Version 22 was employed for data analysis. Logistical regression was carried out to determine the determinants of DRPs. A p-value < 0.05 was considered to be statistically significant.ResultsOf 201 neonates with sepsis included in this study, 125 (62.2%) were males and the median age of the neonate was 5 days. The mean (±standard deviation) number of medications taking during their hospital stay was 2.6 ± 0.7. DRPs were identified in 98 neonates, at a rate of 48.8% (95% CI, 41.7–55.9). Dose too high (42, 35.8%) and need additional drug therapy (40, 34.1%) were the commonly identified DRPs. Taking antibiotics plus other medications (Adjusted Odds Ratio (AOR) =5.2, 95%CI [1.2–22.0], p = 0.02) was a determinant factor for the occurrence of DRPs.ConclusionThe burdens of DRPs occurrence were high in hospitalized neonates with sepsis. The most common DRPs identified were dose too high and need additional drug therapy. Combined use of other medicines with antibiotics was a predictor of DRP occurrence. The innovative way to tackle the occurrence of DRPs, such as the incorporation of clinical pharmacy service provider into the neonatal care team, which will prevent, detect and/or minimize the occurrence of DRPs, is highly recommended.
Highlights
Neonatal populations are quite susceptible to drug-related problems (DRPs) because of clinical heterogeneity and clinical practice trends
One hundred twenty-two (60.6%) neonates were diagnosed with earlyonset neonatal sepsis (EONS) (Table 1)
Drug related problems identified among neonates with sepsis Among the study population, a total of 121 DRPs were identified in 98 neonates with a rate of 48.8% [95% CI, 41.7–55.9]
Summary
Neonatal populations are quite susceptible to drug-related problems (DRPs) because of clinical heterogeneity and clinical practice trends. Studies reporting DRPs in the neonatal population are quite limited. Because of the immaturity of their immune system, neonates tend to become infected . There is a likelihood of developing a serious infection such as neonatal sepsis, which requires pharmacological and non-pharmacological intervention [2]. Many patients do not receive the intended beneficial effects of their treatment as a result of DRPs [3]. It is defined as a drugrelated event or circumstance that or potentially interferes with desired health outcomes and it is classified into seven domains to support the assessment of indication, effectiveness, safety, and adherence [4, 5]. The domains include unnecessary drug therapy, the need for additional drug therapy, ineffective drug, dosage too low, dosage too high, adverse drug reactions, and non-compliance [5]
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