[Adequacy of pharmaceutical prescriptions in a neonatal intensive care unit]

The employment of medicaments in children is complicated, so much more minor all that is the patient and if it is deposited in special units. We try to describe their use in a neonatal intensive care unit, to verify their adequacy with regard to the current guides and the reasons of the wrong prescriptions.

A market study was realized for one year. One classified the medicaments as indicated, not indicated and out of indication, according to their specification sheet. The classification of the patients was carried out considering their weight to the birth and pathology. 41 patients entered. The average weight was 2122.2+/-1167.5 g. The average time of revenue in neonatal intensive care unit was 11.9+/-20.2 days. There were registered 172 pharmaceutical prescriptions, corresponding 33 active principles. The average number of treatments was of 5.1 for patient. The most prescribed medicaments were ampiciline (31), gentamicine (31), teofiline (15), surfactant exogenous (11) and midazolam (10). The group that received more treatments was that of minors of 750 g with complications (17.3+/-19.7 for patient). The most frequent indication was a risk of infection for vertical transmission (59), followed of pauses of apnea (21), sedation (14), sepsis (14) and hyaline membrane disease (11). Were indicated 61 medicaments (35%), out of indication 100 (58%), and not indicated 11 (6%). The reasons of classification as not indicated or out of indication more frequent were the age of the patient (52) and the indication for the one that used (52).

More than the half of the prescribed medicaments are not indicated or out of indication to their specification sheet. Of 33 active principles, more than the half (18) are indicated according to their specification sheet. The medicines used for the most frequent entities (prevention vertical infection, pause of apnea, sepsis and sedation) are not adapted as exposed in their specification sheet.