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Antimicrobial drug-related problems in a neonatal intensive care unit

ABSTRACT

Objective:

The goal was to determine the main drug-related problems in neonates who were using antimicrobials.

Method:

This was an observational, prospective and longitudinal study. Drug-related problems were classified according to version 6.2 of the Pharmaceutical Care Network Europe Foundation classification. A descriptive analysis was performed, in which the clinical and therapeutic variables were presented as absolute and relative frequencies or as the mean and standard deviation, as appropriate.

Results:

In total, 152 neonates with a predominance of males (58.5%), gestational age of 32.7 ± 4.2 weeks and weight of 1,903.1 ± 846.9g were included. The main diagnostic hypothesis of infection was early sepsis (66.5%), and 71.7% of the neonates had some risk factor for infection. Among the neonates, 33.6% had at least one drug-related problem. Of these, 84.8% were related to treatment effectiveness and 15.2% to adverse reactions. The main cause of drug-related problems was the selected dose, particularly for aminoglycosides and cephalosporins.

Conclusion:

The use of antimicrobials in the neonatal intensive care is mainly associated with problems related to medication effectiveness, predominantly the prescription of subdoses of antimicrobials, especially aminoglycosides.

Keywords:
Medication errors; Anti-infective agents; Intensive care units, neonatal; Aminoglycosides; Infant, newborn

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