Antimicrobial drug-related problems in a neonatal intensive care unit

Nunes, Bruna Meirelly; Xavier, Tatiana Costa; Martins, Rand Randall

doi:10.5935/0103-507x.20170040

Cited by 15 publications

(17 citation statements)

References 24 publications

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“…A total of 4181 potentially eligible records were identified from the search. Full texts of 35 records were read, and a total of 18 studies met the inclusion criteria 5,7–11,19–30 . The screening process and results are shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of the prevalence and nature of drug‐related problems in paediatric patients

Zeng

Zhang

2022

Clinical Pharmacy Therapeu

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What is known and objective: A drug-related problem (DRP) is "an event or circumstance involving drug therapy that actually or potentially interferes with the desired health outcome." The paediatric population is easily affected by DRPs. The aim of this study was to evaluate different types and characteristics of DRPs in paediatric patients. This finding can be used as a baseline in epidemiology for assessing potential risk factors for DRPs in paediatric patients.Methods: An extensive search strategy was designed to retrieve all articles published from the date of inception of the database to 1 May 2020, by combining the terms "drug-related problem" and "paediatric" in several electronic databases (PubMed, Cochrane Library, Embase and Web of Science) and following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Observational and interventional studies report that the epidemiology of DRPs in paediatric patients was included. Two reviewers independently screened studies, extracted data, assessed the quality of the included studies and then qualitatively analysed the results.Results: Eighteen studies were included in the final analysis, and 6 different classification systems on paediatric-related DRPs were reported. Overall, these studies showed that paediatric patients are easily affected by DRPs. However, the majority of DRPs are considered preventable, and the severity of DRPs in paediatric patients is mostly considered minor and moderate. Dosing-related problems rank highest in terms of frequency, and the number of prescribed drugs has a positive correlation with the occurrence of DRPs. What is new and conclusion:This study showed that paediatric patients are easily affected by DRPs, but the majority of DRPs are preventable, which indicate that actions should be taken. To reduce DRPs in paediatric patients of the interventions that are noticed, clinical pharmacy services show promising improvement on reducing DRPs compared with other interventions.

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Section: Resultsmentioning

confidence: 99%

“…Twelve studies examined the incidence of DRPs 5,7–9,19–26 . Bizuneh 2020 assessed DRPs in a paediatric ward in Ethiopia using a prospective observational method; 81 patients were included, and 71 (87.7%) of them had at least one DRP, indicating that the actual incidence of DRPs could be substantially higher than reported 20 .…”

Section: Resultsmentioning

confidence: 99%

Systematic review of the prevalence and nature of drug‐related problems in paediatric patients

Zeng

Zhang

2022

Clinical Pharmacy Therapeu

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“…Strong and expensive antimicrobials agents have been extensively developed, but the mortality and morbidity of infants with sepsis are still high [21, 31, 32]. Adjuvant therapies using pentoxifylline have gained the great interest in clinical work [14].…”

Section: Discussionmentioning

confidence: 99%

RETRACTED ARTICLE: Efficacy of pentoxifylline treatment for neonatal sepsis: a meta-analysis of randomized controlled studies

et al. 2019

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Introduction Pentoxifylline may be an important approach to treat neonatal sepsis. However, its use has not been well established. We conduct a systematic review and meta-analysis to evaluate the efficacy of pentoxifylline treatment for neonatal sepsis. Methods PubMed, Embase, and the Cochrane Central Register of Controlled Trials are searched. Randomized controlled trials (RCTs) assessing the influence of pentoxifylline treatment on neonatal sepsis are included. Two investigators independently have searched articles, extracted data, and assessed the quality of included studies. This meta-analysis is performed using the random-effect model. Results Seven RCTs involving 439 patients are included in the meta-analysis. Compared with control intervention for neonatal sepsis, pentoxifylline treatment is associated with reduced hospital stay (Std. MD = -0.61; 95% CI = -0.93 to − 0.29; P = 0.0002) and metabolic acidosis (RR = 0.38; 95% CI = 0.22 to 0.66; P = 0.0006), but has no remarkable impact on mortality (RR = 0.59; 95% CI = 0.30 to 1.16; P = 0.13), serum TNF-α (Std. MD = -0.38; 95% CI = -1.29 to 0.52; P = 0.41), serum CRP (Std. MD = -0.25; 95% CI = -0.92 to 0.42; P = 0.47), plasma IL-6 (Std. MD = -0.13; 95% CI = -0.41 to 0.15; P = 0.37), disseminated intravascular coagulopathy (RR = 0.55; 95% CI = 0.25 to 1.21; P = 0.14), and oliguria/anuria (RR = 0.77; 95% CI = 0.28 to 2.16; P = 0.62). In addition, pentoxifylline treatment can significantly reduce mortality (RR = 0.50; 95% CI = 0.29 to 0.88; P = 0.02) after excluding the study conducted by Akdag during the sensivity analysis. Conclusions Pentoxifylline treatment may be associated with reduced mortality and hospital stay in neonatal sepsis.

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“…Neonates, in particular, are quite susceptible to DRPs because of clinical heterogeneity (i.e. rapid body growth/weight change, gestational age, postnatal age, and physiological immaturity) as well as clinical practice patterns such as dose calculation as a function of body weight [ 11 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

Drug-related problems and its determinant among hospitalized neonates with sepsis at Jimma University Medical Center, Ethiopia: a prospective observational study

Yizengaw

Melaku

Beshir

2021

J Pharm Health Care Sci

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Background Neonatal populations are quite susceptible to drug-related problems (DRPs) because of clinical heterogeneity and clinical practice trends. However, studies reporting DRPs in the neonatal population are quite limited. Objective This study aimed to assess the magnitude and types of DRPs and determinant factors among neonates admitted with neonatal sepsis at the Neonatal Intensive Care Unit (NICU) of the Jimma University Medical Center (JUMC), Ethiopia. Methods A hospital-based prospective observational study was conducted involving 201 neonates with sepsis admitted to the NICU from May to August 30, 2018. DRPs were classified using Cipolle’s classification method. Statistical Package for Social Science Version 22 was employed for data analysis. Logistical regression was carried out to determine the determinants of DRPs. A p-value < 0.05 was considered to be statistically significant. Results Of 201 neonates with sepsis included in this study, 125 (62.2%) were males and the median age of the neonate was 5 days. The mean (±standard deviation) number of medications taking during their hospital stay was 2.6 ± 0.7. DRPs were identified in 98 neonates, at a rate of 48.8% (95% CI, 41.7–55.9). Dose too high (42, 35.8%) and need additional drug therapy (40, 34.1%) were the commonly identified DRPs. Taking antibiotics plus other medications (Adjusted Odds Ratio (AOR) =5.2, 95%CI [1.2–22.0], p = 0.02) was a determinant factor for the occurrence of DRPs. Conclusion The burdens of DRPs occurrence were high in hospitalized neonates with sepsis. The most common DRPs identified were dose too high and need additional drug therapy. Combined use of other medicines with antibiotics was a predictor of DRP occurrence. The innovative way to tackle the occurrence of DRPs, such as the incorporation of clinical pharmacy service provider into the neonatal care team, which will prevent, detect and/or minimize the occurrence of DRPs, is highly recommended.

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Antimicrobial drug-related problems in a neonatal intensive care unit

Cited by 15 publications

References 24 publications

Systematic review of the prevalence and nature of drug‐related problems in paediatric patients

Systematic review of the prevalence and nature of drug‐related problems in paediatric patients

RETRACTED ARTICLE: Efficacy of pentoxifylline treatment for neonatal sepsis: a meta-analysis of randomized controlled studies

Drug-related problems and its determinant among hospitalized neonates with sepsis at Jimma University Medical Center, Ethiopia: a prospective observational study

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