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新生儿和小儿安全辅料暴露——SEEN项目方案

Safe excipient exposure in neonates and small children - protocol for the SEEN project.

作者信息

Valeur Kristine Svinning, Hertel Steen Axel, Lundstrøm Kaare Engell, Holst Helle

出版信息

Dan Med J. 2017 Feb;64(2).

Abstract

INTRODUCTION

The pharmacokinetics of excipients in neonates differs from that of older children. In a recent pan--European survey, two thirds of neonates received at least one potentially harmful excipient, such as ethanol and benzoates. The content of sweeteners varied by route of administration (more common by enteral than parenteral route), and regional differences were revealed. The survey did not identify if the content of excipients was more pronounced in medications prescribed for specific medical diseases, e.g. more common in cardiovascular conditions than lung diseases. Furthermore, the quantitative amount of e.g. ethanol in the multi-medicated neonate has not been investigated. The aim of the present study was to quantify the total amount of excipients administered to poly-medicated neonatal and paediatric patients during hospitalisation; and to investigate if any particular medical diseases are treated with potentially harmful excipients.

METHODS

This is a retrospective cohort study based on chart-audit on multi-medicated patients ≤ 5 years of age treated at the Rigshospitalet, Denmark. Preparations with ethanol, propylene glycol, benzyl alcohol, parabens, acesulfame p, aspartame, glycerol, sorbitol and polysorbate-80 will be recorded and cumulative amounts will be calculated.

CONCLUSION

By quantifying the amount of harmful excipients to which paediatric patients are exposed, the study will contribute to a risk/benefit assessment of the medication standards of neonatal and paediatric patients.

FUNDING

The Danish Council for Independent Research, grant-id: DFF - 6110-00266.

TRIAL REGISTRATION

This study was registered at clinicaltrials.gov (reg. no. NCT02545712).

摘要

引言

新生儿辅料的药代动力学与大龄儿童不同。在最近一项泛欧洲调查中,三分之二的新生儿至少接受了一种潜在有害的辅料,如乙醇和苯甲酸盐。甜味剂的含量因给药途径而异(肠内给药比肠外给药更常见),并且存在地区差异。该调查未确定特定疾病所开药物中辅料含量是否更显著,例如心血管疾病用药中比肺部疾病用药中更常见。此外,多药联用新生儿体内乙醇等辅料的定量情况尚未得到研究。本研究的目的是量化住院期间多药联用的新生儿和儿科患者所使用辅料的总量;并调查是否有特定疾病使用了潜在有害辅料进行治疗。

方法

这是一项基于丹麦哥本哈根大学医院对5岁及以下多药联用患者病历审核的回顾性队列研究。将记录含有乙醇、丙二醇、苯甲醇、对羟基苯甲酸酯、乙酰磺胺酸钾、阿斯巴甜、甘油、山梨醇和聚山梨酯80的制剂,并计算累积量。

结论

通过量化儿科患者接触的有害辅料量,本研究将有助于对新生儿和儿科患者用药标准进行风险/效益评估。

资助

丹麦独立研究理事会,资助编号:DFF - 6110-00266。

试验注册

本研究已在clinicaltrials.gov注册(注册号:NCT02545712)。

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