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Potential intravenous drug incompatibilities in a pediatric unit
Karla Dalliane Batista Leal1, Ramon Weyler Duarte Leopoldino1, Rand Randall Martins1
1Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.
Insights
This study found that most pediatric intravenous drug prescriptions had potential incompatibilities, with "non-tested" types being most common. The number of drugs and specific medications like diazepam were identified as risk factors.
Area of Science:
- Pharmacology
- Pediatric Medicine
- Drug Safety
Background:
- Intravenous drug incompatibilities pose risks in pediatric care.
- Identifying risk factors is crucial for patient safety in pediatric units.
Purpose of the Study:
- To investigate potential intravenous drug incompatibilities in a pediatric unit.
- To identify risk factors associated with these incompatibilities.
Main Methods:
- A cross-sectional analytical study was conducted in a Brazilian university hospital's pediatric unit.
- Data from 222 children (aged 0-15 years) were analyzed for intravenous drug prescriptions.
- Statistical tests (Student's t test, ANOVA) and relative risk calculations were used to identify associations.
Main Results:
- Approximately 85% of pediatric patients exhibited at least one potential intravenous drug incompatibility.
- The most common incompatibility type was 'non-tested' (93.4%).
- Increased number of drugs, and prescription of diazepam, phenobarbital, phenytoin, or metronidazole were significant risk factors.
Conclusions:
- A high prevalence of potential intravenous drug incompatibilities exists in pediatric prescriptions.
- Non-tested incompatibilities are the most frequent type.
- Polypharmacy and specific drug combinations increase the risk of incompatibilities in pediatric patients.
Objective:
To investigate potential intravenous drug incompatibilities and related risk factors in a pediatric unit.
Methods:
A cross-sectional analytical study conducted in the pediatric unit of a university hospital in Brazil. Data on prescriptions given to children aged 0-15 years from June to October 2014 were collected. Prescriptions that did not include intravenous drugs and prescriptions with incomplete dosage regimen or written in poor handwriting were excluded. Associations between variables and the risk of potential incompatibility were investigated using the Student's t test and ANOVA; the level of significance was set at 5% (p<0.05). Relative risks were calculated for each drug involved in potential incompatibility with 95% confidence interval.
Results:
A total of 222 children participated in the study; 132 (59.5%) children were male and 118 (53.2%) were aged between 0 and 2 years. The mean length of stay was 7.7±2.3 days. Dipyrone, penicillin G and ceftriaxona were the most commonly prescribed drugs. At least one potential incompatibility was detected in about 85% of children (1.2 incompatibility/patient ratio). Most incompatibilities detected fell into the non-tested (93.4%), precipitation (5.5%), turbidity (0.7%) or chemical decomposition (0.4%) categories. The number of drugs and prescription of diazepam, phenytoin, phenobarbital or metronidazole were risk factors for potential incompatibility.
Conclusion:
Most pediatric prescriptions involved potential incompatibilities, with higher prevalence of non-tested incompatibilities. The number of drugs and prescription of diazepam, phenobarbital, phenytoin or metronidazole were risk factors for potential incompatibilities.
Objetivo:
Avaliar o potencial de incompatibilidade dos medicamentos intravenosos, identificando possíveis fatores de risco em uma unidade pediátrica.
MéTodos:
Trata-se de um estudo observacional analítico do tipo transversal realizado na unidade de pediatria de um hospital de ensino no Brasil. Os dados foram coletados de junho a outubro de 2014 a partir da análise das prescrições de crianças (0 a 15 anos) hospitalizadas. Foram excluídas prescrições sem medicamento intravenoso e com posologia incompletas ou grafia inadequada. A associação entre as variáveis e o risco de potenciais incompatibilidades foi determinada pelo teste t de Student e ANOVA, considerando significativo para p<0,05. Calculou-se o risco relativo com intervalo de confiança de 95% de cada medicamento envolvido.
Resultados:
Duzentos e vinte e duas crianças participaram do estudo, 132 (59,5%) eram do gênero masculino, 118 (53,2%) tinham idade entre 0 a 2 anos e estiveram internados em média 7,7±2,3 dias. Os medicamentos mais prescritos foram dipirona, penicilina G e ceftriaxona. Quase 85% das crianças apresentaram ao menos uma potencial incompatibilidade, razão de 1,2 incompatibilidades/paciente. Os tipos de incompatibilidades mais comuns foram: não testada (93,4%), precipitação (5,5%), turbidez (0,7%) e decomposição química (0,4%). Os fatores associados a potenciais incompatibilidades foram: número de medicamentos e a prescrição dos medicamentos diazepam, fenitoína, fenobarbital e metronidazol.
ConclusãO:
A maioria das prescrições pediátricas apresentou potenciais incompatibilidades e a incompatibilidade não testada foi o tipo mais comum. O número de medicamentos e a prescrição dos medicamentos diazepam, fenobarbital, fenitoína e metronidazol foram fatores de risco para potenciais incompatibilidades.
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