Abstract
To evaluate the use of drugs with pharmacogenomic (PGx) guidelines from the Clinical Pharmacogenetics Implementation Consortium (CPIC) in early childhood. A retrospective observational study of neonatal intensive care (NICU) patients admitted between 2005 - 2018 with at least one subsequent hospitalization at or after 5 years of age was performed to determine PGx-drug exposure. Data regarding hospitalizations, drug exposures, gestational age, birth weight, and congenital anomalies and/or a primary genetic diagnosis were collected. Incidence of PGx-drug and drug class exposures was determined and patient specific factors predictive of exposure were investigated. During the study, 19,195 patients received NICU care and 4,196 (22%) met study inclusion; 67% received 1-2, 28% 3-4, and 5% 5 or more PGx-drugs in early childhood. Preterm gestation, low birth weight (<2,500 grams), and the presence of any congenital anomalies and/or a primary genetic diagnosis were statistically significant predictors of CPIC drug exposures (p<0.01, p<0.01, p<0.01, respectively). Preemptive PGx testing in NICU patients could have a significant impact on medical management, during the NICU stay and throughout early childhood.
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