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Audit of drug usage in a regional neonatal intensive care unit
1Department of Paediatrics, Christchurch School of Medicine, Christchurch Hospital, New Zealand.
Insights
Neonatal intensive care unit (NICU) drug use was audited, revealing significant differences in medication exposure based on birth weight. Premature infants received substantially more drugs, including some not recommended for newborns.
Area of Science:
- Neonatalogy
- Clinical Pharmacy
- Pharmacology
Background:
- Drug utilization in neonatal intensive care units (NICUs) requires careful monitoring.
- Premature infants and those with low birth weight often have complex medical needs requiring multiple medications.
Purpose of the Study:
- To prospectively audit drug utilization in a regional NICU.
- To analyze drug exposure patterns in relation to infant birth weight.
Main Methods:
- Prospective audit of all infants in a regional NICU over a 3-month period.
- Data collection included infant birth weight, number and type of drugs administered, and route of administration.
Main Results:
- A total of 76 different drugs were used, with a mean of 8.6 drugs per infant (range 0-30).
- Infants with birth weights <1500 g received a mean of 14.5 drugs, compared to 4.8 drugs for those >1500 g.
- Three drugs with contraindications for newborns were administered, one to 13% of infants.
Conclusions:
- Drug exposure in the NICU is substantial, particularly for low birth weight infants.
- The use of medications with known risks in neonates warrants further investigation and potential intervention.
Abstract:
Drug utilization has been audited prospectively for all infants cared for in a regional neonatal intensive care unit for a 3-month period. Twenty-five infants had a birthweight less than 1500 g and 54 had a birthweight greater than 1500 g. The total number of different drugs used was 76 and the mean number received was 8.6 with a range of 0-30. Infants with birthweights less than 1500 g received a mean of 14.5 drugs and infants with birthweights greater than 1500 g received a mean of 4.8 drugs. Almost two-thirds (63%) of doses were given orally, 20% intravenously and 10% via an umbilical artery catheter. Three drugs, one of which was received by 13% of infants, carried manufacturers' inserts advising against use in premature infants or the newborn.
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