Characteristics of prescription in 29 Level 3 Neonatal Wards over a 2-year period (2017-2018). An inventory for future research
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Béatrice Gouyon aff001; Séverine Martin-Mons aff001; Silvia Iacobelli aff001; Hasinirina Razafimahefa aff002; Elsa Kermorvant-Duchemin aff003; Roselyne Brat aff004; Laurence Caeymaex aff005; Yvan Couringa aff006; Ceneric Alexandre aff007; Catherine Lafon aff008; Duksha Ramful aff009; Francesco Bonsante aff001; Guillaume Binson aff010; Florence Flamein aff011; Amélie Moussy-Durandy aff012; Massimo Di Maio aff013; Gaël Mazeiras aff014; Olivier Girard aff015; Cécile Desbruyeres aff016; Julien Mourdie aff017; Guillaume Escourrou aff018; Olivier Flechelles aff019; Soumeth Abasse aff020; Jean-Marc Rosenthal aff021; Anne-Sophie Pages aff022; Marine Dorsi aff023; Léila Karaoui aff024; Abdellah ElGellab aff025; Florence Le Bail Dantec aff026; Mohamed-Amine Yangui aff027; Karine Norbert aff028; Yaovi Kugbe aff029; Simon Lorrain aff001; Anaelle Pignolet aff001; Elodie Marie Garnier aff001; Alexandre Lapillonne aff003; Delphine Mitanchez aff030; Evelyne Jacqz-Aigrain aff031; Jean-Bernard Gouyon aff001
Působiště autorů:
Centre d’Etudes Périnatales de l’Océan Indien (EA 7388), Centre Hospitalier Universitaire de La Réunion – Site Sud, Saint Pierre, Réunion, France
aff001; Centre Hospitalier Sud Francilien, Corbeil-Essonnes, France
aff002; Hôpital Necker-Enfants Malades, Paris, France
aff003; Centre Hospitalier Régional d’Orléans, Orléans, France
aff004; Centre Hospitalier Intercommunal de Créteil, Créteil, France
aff005; Centre Hospitalier Andrée-Rosemon, Guyane Française, France
aff006; Centre Hospitalier Universitaire de Caen, Caen, France
aff007; Centre Hospitalier d’Arras, Arras, France
aff008; Centre Hospitalier Universitaire de La Réunion – Site Nord, Saint Denis, Réunion, France
aff009; Centre Hospitalier Universitaire de Poitiers, Poitiers, France
aff010; Centre Hospitalier Universitaire de Lille, Lille, France
aff011; Centre Hospitalier Intercommunal Poissy/Saint Germain en Laye, Poissy, France
aff012; Centre Hospitalier Universitaire de Nîmes, Nîmes, France
aff013; Centre Hospitalier de la Côte Basque, Bayonne, France
aff014; Centre Hospitalier de Saint Denis, Saint Denis, France
aff015; Centre Hospitalier Métropole Savoie, Chambéry, France
aff016; Hôpital Jacques Monod – Groupe Hospitalier du Havre, Montivilliers, France
aff017; Centre Hospitalier Intercommunal André Grégoire, Montreuil, France
aff018; Centre Hospitalier Universitaire de Fort-de-France, Fort de France, Martinique, France
aff019; Centre Hospitalier de Mayotte, Mayotte, France
aff020; Centre Hospitalier Universitaire de Pointe-à-Pitre, Guadeloupe, France
aff021; Centre Hospitalier Public du Cotentin, Cherbourg-en-Cotentin, France
aff022; Centre Hospitalier Territorial Gaston-Bourret, Dumbéa, Nouvelle Calédonie, France
aff023; Grand Hôpital de l’Est Francilien, Meaux, France
aff024; Centre Hospitalier de Lens, Lens, France
aff025; Centre Hospitalier de Saint Brieuc, Saint Brieuc, France
aff026; Hôpital René Dubos, Pontoise, France
aff027; Centre Hospitalier de Pau, Pau, France
aff028; Centre Hospitalier de l’Ouest Guyanais – Franck Joly, Saint Laurent du Maroni, Guyane Française, France
aff029; Hôpital Armand-Trousseau, Paris, France
aff030; Hôpital Robert Debré, Paris, France
aff031
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0222667
Souhrn
Objectives
The primary objective of this study is to determine the current level of patient medication exposure in Level 3 Neonatal Wards (L3NW). The secondary objective is to evaluate in the first month of life the rate of medication prescription not cited in the Summary of Product Characteristics (SmPC). A database containing all the medication prescriptions is collected as part of a prescription benchmarking program in the L3NW.
Material and methods
The research is a two-year observational cohort study (2017–2018) with retrospective analysis of medications prescribed in 29 French L3NW. Seventeen L3NW are present since the beginning of the study and 12 have been progressively included. All neonatal units used the same computerized system of prescription, and all prescription data were completely de-identified within each hospital before being stored in a common data warehouse.
Results
The study population includes 27,382 newborns. Two hundred and sixty-one different medications (International Nonproprietary Names, INN) were prescribed. Twelve INN (including paracetamol) were prescribed for at least 10% of patients, 55 for less than 10% but at least 1% and 194 to less than 1%. The lowest gestational ages (GA) were exposed to the greatest number of medications (18.0 below 28 weeks of gestation (WG) to 4.1 above 36 WG) (p<0.0001). In addition, 69.2% of the 351 different combinations of an medication INN and a route of administration have no indication for the first month of life according to the French SmPC. Ninety-five percent of premature infants with GA less than 32 weeks received at least one medication not cited in SmPC.
Conclusion
Neonates remain therapeutic orphans. The consequences of polypharmacy in L3NW should be quickly assessed, especially in the most immature infants.
Klíčová slova:
Medicine and health sciences – Pediatrics – Neonatology – Neonatal care – Pharmacology – Routes of administration – Drugs – Health care – Cardiology – Biology and life sciences – Developmental biology – Neonates – Microbiology – Microbial control – Antimicrobials – Antibiotics – Physical sciences – Chemistry – Chemical compounds – Alkaloids – Caffeine – Organic compounds – Vitamins – Organic chemistry
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