Patterns of drug utilization in a neonatal intensive care unit

Abstract

Background/Aims Pharmacological agents are extensively used in neonatal intensive care settings but their utilization rates in neonates including premature infants is an area that has not been studied in great detail. This study determined the types, patterns and frequency of drug use in sick newborns to identify educational and research priorities in neonatal drug therapy. Methods Data that had been prospectively collected in 6860 neonates admitted to the neonatal intensive care unit (ICU) / progressive care nursery (PCN) at a maternity hospital between 1997 and 2003 were analyzed retrospectively. Results A total of 107 different drugs used in a predominantly African-American (~80%) population were studied. Mean length of ICU/PCN stay was 15±24 days, birthweight (BW) 2494±1002 grams and gestational age (GA) 35±5 weeks. Drug exposure rates (fig 1) were highest for antibiotics. The highest average drug usage was in the 24–27 week GA group at 12.4/infant followed by the <23 week GA category at 10.5/infant. Factors associated with increased risk of drug exposure by multivariate analysis were: Caucasian ethnicity, male gender, GA <28 week and BW <1000 grams. Conclusions Antibiotics are the most commonly used drugs, far outweighing any other category, with >90% of infants being exposed to them. Future research and educational efforts should be directed to areas of appropriate antibiotic therapy in neonates with priority assigned to very low birth weight infants. Clinical Pharmacology & Therapeutics (2005) 77, P30–P30; doi: 10.1016/j.clpt.2004.12.007