Abstract
Factors possibly associated with increased use of drug exposure in a NICU were evaluated prospectively in all neonates admitted to NICU since Feb 1977. Demographic, clinical and laboratory data on all babies (Bb) were recorded by a physician/nurse monitor team and stored in the computer. Analyses of data from the first 461 neonates (bt wgt range 734-4850 g, gestational age (GA) 24-43 wks) show that 128 different drugs were used. 76.1% of babies received 1 to 35 drugs (excluding routine Vit K and AgNO3) with a mean exposure of 4.6/Bb. Babies with GA <32 wks (18%) had 3X more drug exposure than those with GA >32 wks (9.7 vs 3.4 drugs/Bb). GA and bt wgt were inversely related with drug exposure (number of drugs/Bb). Drug exposure was greater in disease states more commonly associated with prematurity; 14.2 drugs/Bb in PDA, 16.8 in necrotizing enterocolitis, 14.5 in persistent fetal circulation, 12.5 in renal failure, 13.1 in liver disease. 17 different antimicrobials were used in 47.7% of Bb, diuretics in 17.4%, cardiovascular drugs in 9.8%, steroids in 4.3% and sedatives and narcotics for palliation in 13.0%. Mean bt wgts and GA were significantly lower in babies who received antimicrobials, diuretics, and methylxanthines. Data underscore the necessity of requisite pharmacologic studies in the low bt wgt infants who are at greater risk of drug exposure.
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Aranda, J., Collinge, J., Seliske, P. et al. 308 DETERMINANTS OF DRUG EXPOSURE IN A NEWBORN INTENSIVE CARE UNIT (NICU). Pediatr Res 15 (Suppl 4), 491 (1981). https://doi.org/10.1203/00006450-198104001-00319
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DOI: https://doi.org/10.1203/00006450-198104001-00319
