Open AccessPrescription of off-label and unlicensed drugs for preterm infants in a neonatal intensive care unit
Author(s) -
Verônica Cheles Vieira,
Renart Santos Costa,
Raquel Cristina Gomes Lima,
Daiane Borges Queiroz,
Danielle Souto de Medeiros
Publication year - 2021
Publication title -
revista brasileira de terapia intensiva
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.431
H-Index - 19
eISSN - 1982-4335
pISSN - 0103-507X
DOI - 10.5935/0103-507x.20210034
Subject(s) - medicine , neonatal intensive care unit , gestational age , medical prescription , off label use , intensive care , neonatology , apgar score , birth weight , pediatrics , cohort , emergency medicine , intensive care medicine , pregnancy , pharmacology , genetics , biology
Objective To evaluate the use of off-label and unlicensed medications in preterm infants hospitalized in a neonatal intensive care unit. Methods This nonconcurrent cohort study included preterm infants admitted to 3 neonatal intensive care units in 2016 and 2017 who were followed up during the neonatal period. The type and number of medications used were recorded for the entire period and classified based on the Anatomical Therapeutic Chemical. Descriptive and bivariate data analyses were performed to assess associations between the number of drugs used (total, off-label and unlicensed) and the explanatory variables of interest. Results Four hundred preterm infants received 16,143 prescriptions for 86 different pharmaceuticals; 51.9% of these medications were classified as off-label and 23.5% as unlicensed. The most prescribed drugs were gentamicin and ampicillin (17.5% and 15.5% among off-label, respectively) and caffeine (75.5% among unlicensed). The results indicated significant associations between the use of off-label drugs and lower gestational age, low birth weight, lower 5-minute Apgar score, advanced resuscitation maneuver in the delivery room and death. The prescription of unlicensed drugs was associated with lower gestational age, low birth weight and 5-minute Apgar score below 7. Conclusion Neonates admitted to neonatal intensive care units are highly exposed to off-label and unlicensed medications. Further studies are needed to achieve greater safety and quality of drug therapy used in neonatology.