Drug utilization in a neonatal intensive care unit in Egypt

الملخص EN

Background : Newborns in the neonatal intensive care unit (NICU) are exposed to a large number of drugs and are especially vulnerable to adverse drug reactions.

It is important to review changes in drug use patterns periodically in the neonatal intensive care unit (NICU) to identify newly introduced drugs as well as drugs with increasing use.

Aims : To study the actual drug utilization patterns and to identify the most commonly used drugs in neonates.

Methods : A retrospective review of all the demographic and clinical data in NICU of Cairo University Pediatric Hospital (CUPH) was performed.

We also collected information on all medications dispensed for neonates admitted to this tertiary care unit over a 2-year period.

Results : There were a total of 2070 admissions, of which 1309 neonates received at least one drug.

Among these patients 54.8 % were males, 38.1% were preterm.

The mean birth weight, gestational age, and length of hospital stay for the whole group were 2433.

3 ± 855g, 32.

8 ± 3.

1 weeks, and 13.

3 ± 13.

7 days respectively.

The mean number of drugs in full term babies was 3.39+2.05 and increased to7.85±1.99in infants below 29 weeks gestation.

There was a statistically negative correlation between the mean number of drugs used per infant and gestational age in weeks (r = -0.

573, p < 0.001) and also between the number of drugs used per infant with the birth weight groups (r= -0.

445, p < 0.

001).

The most commonly used drugs were antibiotics and pressor agents.

Ampicillin, followed by Ampicillin / Sulbactam, Cefotaxime and Gentamycin (66.

3 %, 54.

5, 53.

8, and37.

7 % respectively) had the highest exposure rate.

A fatality rate of 16.

1 % was detected and a significant association was found between fatality rate and the number of drugs used per infant (p < 0.

001).

Conclusion : The trend toward polypharmacy continues in neonates in the NICU, and drug exposure continues to be dictated by gestational age and/or birth weight.

These data are useful for further studies monitoring drug resistance patterns, adverse drug reactions, and prioritizing areas of relevant therapeutic research.