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Medication Use in the Neonatal Intensive Care Unit and Changes from 2010 to 2018.

Publication ,  Journal Article
Stark, A; Smith, PB; Hornik, CP; Zimmerman, KO; Hornik, CD; Pradeep, S; Clark, RH; Benjamin, DK; Laughon, M; Greenberg, RG
Published in: J Pediatr
January 2022

OBJECTIVE: To provide up-to-date medication prescribing patterns in US neonatal intensive care units (NICUs) and to examine trends in prescribing patterns over time. STUDY DESIGN: We performed a cohort study of 799 016 infants treated in NICUs managed by the Pediatrix Medical Group from 2010 to 2018. We used 3 different methods to report counts of medication: exposure, courses, and days of use. We defined the change in frequency of medication administration by absolute change and relative change. We examined the Food and Drug Administration (FDA) package insert for each medication to determine whether a medication was labeled for use in infants and used PubMed to search for pharmacokinetics (PK) studies. RESULTS: The most frequently prescribed medications included ampicillin, gentamicin, caffeine citrate, poractant alfa, morphine, vancomycin, furosemide, fentanyl, midazolam, and acetaminophen. Of the top 50 medications used in infants with extremely low birth weight, only 20 (40%) are FDA-labeled for use in infants; of the 30 that are not labeled for use in infants, 13 (43%) had at least 2 published PK studies. The medications with the greatest relative increase in use from 2010 to 2018 included dexmedetomidine, clonidine, rocuronium, levetiracetam, atropine, and diazoxide. The medications with the greatest relative decrease in use included tromethamine acetate, pancuronium, chloral hydrate, imipenem + cilastatin, and amikacin. CONCLUSION: Trends of medication use in the NICU change substantially over time. It is imperative to identify changes in medication use in the NICU to better inform further prospective studies.

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Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

January 2022

Volume

240

Start / End Page

66 / 71.e4

Location

United States

Related Subject Headings

  • United States
  • Pharmaceutical Preparations
  • Pediatrics
  • Intensive Care Units, Neonatal
  • Infant, Newborn
  • Humans
  • Drug Utilization
  • Databases, Factual
  • Cohort Studies
  • 3213 Paediatrics
 

Citation

APA
Chicago
ICMJE
MLA
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Stark, A., Smith, P. B., Hornik, C. P., Zimmerman, K. O., Hornik, C. D., Pradeep, S., … Greenberg, R. G. (2022). Medication Use in the Neonatal Intensive Care Unit and Changes from 2010 to 2018. J Pediatr, 240, 66-71.e4. https://doi.org/10.1016/j.jpeds.2021.08.075
Stark, Ashley, P Brian Smith, Christoph P. Hornik, Kanecia O. Zimmerman, Chi D. Hornik, Sidart Pradeep, Reese H. Clark, Daniel K. Benjamin, Matthew Laughon, and Rachel G. Greenberg. “Medication Use in the Neonatal Intensive Care Unit and Changes from 2010 to 2018.J Pediatr 240 (January 2022): 66-71.e4. https://doi.org/10.1016/j.jpeds.2021.08.075.
Stark A, Smith PB, Hornik CP, Zimmerman KO, Hornik CD, Pradeep S, et al. Medication Use in the Neonatal Intensive Care Unit and Changes from 2010 to 2018. J Pediatr. 2022 Jan;240:66-71.e4.
Stark, Ashley, et al. “Medication Use in the Neonatal Intensive Care Unit and Changes from 2010 to 2018.J Pediatr, vol. 240, Jan. 2022, pp. 66-71.e4. Pubmed, doi:10.1016/j.jpeds.2021.08.075.
Stark A, Smith PB, Hornik CP, Zimmerman KO, Hornik CD, Pradeep S, Clark RH, Benjamin DK, Laughon M, Greenberg RG. Medication Use in the Neonatal Intensive Care Unit and Changes from 2010 to 2018. J Pediatr. 2022 Jan;240:66-71.e4.
Journal cover image

Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

January 2022

Volume

240

Start / End Page

66 / 71.e4

Location

United States

Related Subject Headings

  • United States
  • Pharmaceutical Preparations
  • Pediatrics
  • Intensive Care Units, Neonatal
  • Infant, Newborn
  • Humans
  • Drug Utilization
  • Databases, Factual
  • Cohort Studies
  • 3213 Paediatrics