小儿患者静脉注射对乙酰氨基酚指南实施后的药物使用、剂量及成本
Drug utilization, dosing, and costs after implementation of intravenous acetaminophen guidelines for pediatric patients.
作者信息
Fusco Nicholas M, Parbuoni Kristine, Morgan Jill A
机构信息
Department of Pharmacy Practice, University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, New York.
Department of Pharmacy Practice, Loma Linda University School of Pharmacy, Loma Linda, California.
出版信息
J Pediatr Pharmacol Ther. 2014 Jan;19(1):35-41. doi: 10.5863/1551-6776-19.1.35.
OBJECTIVES
The objectives of this evaluation of medication use were to characterize the use of intravenous acetaminophen at our institution and to determine if acetaminophen was prescribed at age-appropriate dosages per institutional guidelines, as well as to evaluate compliance with restrictions for use. Total acquisition costs associated with intravenous acetaminophen usage is described as well.
METHODS
This retrospective study evaluated the use of acetaminophen in pediatric patients younger than 18 years of age, admitted to a tertiary care hospital, who received at least 1 dose of intravenous acet-aminophen between August 1, 2011, and January 31, 2012.
RESULTS
A total of 52 doses of intravenous acetaminophen were administered to 31 patients during the 6-month study period. Most patients were admitted to the otorhinolaryngology service (55%), and the majority of doses were administered either in the operating room (46%) or in the intensive care unit (46%). Nineteen doses (37%) of intravenous acetaminophen were administered to patients who did not meet institutional guidelines' eligibility criteria. Three patients received single doses of intravenous acetaminophen that were greater than the dose recommended for their age. One patient during the study period received more than the recommended 24-hour maximum cumulative dose for acetaminophen. Total acquisition cost of intravenous acetaminophen therapy over the 6-month study period was $530.40.
CONCLUSIONS
Intravenous acetaminophen was used most frequently among pediatric patients admitted to the otorhinolaryngology service during the perioperative period. Nineteen doses (37%) were administered to patients who did not meet the institutional guidelines' eligibility criteria. Our data support reinforcing the availability of institutional guidelines to promote cost-effective use of intravenous acetaminophen while minimizing the prescription of inappropriate doses.
目的
本次药物使用评估的目的是描述我院静脉注射对乙酰氨基酚的使用情况，根据机构指南确定对乙酰氨基酚的处方剂量是否适合患者年龄，并评估使用限制的遵守情况。同时还描述了与静脉注射对乙酰氨基酚使用相关的总采购成本。
方法
这项回顾性研究评估了2011年8月1日至2012年1月31日期间入住三级护理医院、年龄小于18岁且至少接受过1剂静脉注射对乙酰氨基酚的儿科患者对乙酰氨基酚的使用情况。
结果
在为期6个月的研究期间，共向31例患者施用了52剂静脉注射对乙酰氨基酚。大多数患者入住耳鼻喉科（55%），大多数剂量在手术室（46%）或重症监护病房（46%）施用。19剂（37%）静脉注射对乙酰氨基酚施用于不符合机构指南资格标准的患者。3例患者接受的单次静脉注射对乙酰氨基酚剂量大于其年龄推荐剂量。研究期间有1例患者接受的对乙酰氨基酚剂量超过了推荐的24小时最大累积剂量。在为期6个月的研究期间，静脉注射对乙酰氨基酚治疗的总采购成本为530.40美元。
结论
围手术期入住耳鼻喉科的儿科患者中，静脉注射对乙酰氨基酚的使用最为频繁。19剂（37%）施用于不符合机构指南资格标准的患者。我们的数据支持加强机构指南的可用性，以促进静脉注射对乙酰氨基酚的成本效益使用，同时尽量减少不适当剂量的处方。
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