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新生儿重症监护病房中与抗菌药物相关的问题。

Antimicrobial drug-related problems in a neonatal intensive care unit.

作者信息

Nunes Bruna Meirelly, Xavier Tatiana Costa, Martins Rand Randall

机构信息

Residência Multiprofissional em Saúde, Maternidade Escola Januário Cicco, Universidade Federal do Rio Grande do Norte - Natal (RN), Brasil.

Departamento de Farmácia, Universidade Federal do Rio Grande do Norte - Natal (RN), Brasil.

出版信息

Rev Bras Ter Intensiva. 2017 Jul-Sep;29(3):331-336. doi: 10.5935/0103-507X.20170040. Epub 2017 Sep 4.

Abstract

OBJECTIVE

The goal was to determine the main drug-related problems in neonates who were using antimicrobials.

METHOD

This was an observational, prospective and longitudinal study. Drug-related problems were classified according to version 6.2 of the Pharmaceutical Care Network Europe Foundation classification. A descriptive analysis was performed, in which the clinical and therapeutic variables were presented as absolute and relative frequencies or as the mean and standard deviation, as appropriate.

RESULTS

In total, 152 neonates with a predominance of males (58.5%), gestational age of 32.7 ± 4.2 weeks and weight of 1,903.1 ± 846.9g were included. The main diagnostic hypothesis of infection was early sepsis (66.5%), and 71.7% of the neonates had some risk factor for infection. Among the neonates, 33.6% had at least one drug-related problem. Of these, 84.8% were related to treatment effectiveness and 15.2% to adverse reactions. The main cause of drug-related problems was the selected dose, particularly for aminoglycosides and cephalosporins.

CONCLUSION

The use of antimicrobials in the neonatal intensive care is mainly associated with problems related to medication effectiveness, predominantly the prescription of subdoses of antimicrobials, especially aminoglycosides.

摘要

目的

本研究旨在确定使用抗菌药物的新生儿中主要的药物相关问题。

方法

这是一项观察性、前瞻性和纵向研究。药物相关问题根据欧洲药学保健网络基金会分类第6.2版进行分类。进行了描述性分析,其中临床和治疗变量根据情况以绝对和相对频率或均值和标准差表示。

结果

总共纳入了152例新生儿,其中男性占多数(58.5%),胎龄为32.7±4.2周,体重为1903.1±846.9克。感染的主要诊断假设为早发性败血症(66.5%),71.7%的新生儿有感染的危险因素。在这些新生儿中,33.6%至少有一个药物相关问题。其中,84.8%与治疗效果有关,15.2%与不良反应有关。药物相关问题的主要原因是所选剂量,尤其是氨基糖苷类和头孢菌素类药物。

结论

新生儿重症监护中抗菌药物的使用主要与药物疗效相关问题有关,主要是抗菌药物剂量不足的处方,尤其是氨基糖苷类药物。

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