Division of Pediatric Pharmacology and Pharmacometrics, University of Basel Children's Hospital, Basel, Switzerland,
Department of Pediatric Cardiology, University Children's Hospital, Heidelberg, Germany,
Neonatology. 2019;115(2):108-115. doi: 10.1159/000493119. Epub 2018 Nov 1.
Prescription drug shortages have increased significantly during the past two decades and also impact drugs used in critical care and pediatrics.
To analyze drug shortages affecting medications used in neonatal intensive care units (NICUs).
Drug shortage data for the top 100 NICU drugs were retrieved from the University of Utah Drug Information Service from 2001 to 2016. Data were analyzed focusing on drug class, formulation, reason for shortage, and shortage duration.
Seventy-four of the top 100 NICU drugs were impacted by 227 shortages (10.3% of total shortages). Twenty-eight (12.3%) shortages were unresolved as of December 2016. Resolved shortages had a median duration of 8.8 months (interquartile range 3.6-21.3), and generic drugs were involved in 175 (87.9%). An alternative agent was available for 171 (85.8%) drugs but 120 (70.2%) of alternatives were also affected by shortages. Parenteral drugs were involved in 172 (86.4%) shortages, with longer durations than nonparenteral drugs (9.9 vs. 6.4 months, p = 0.022). The most common shortage reason was manufacturing problems (32.2%).
Drug shortages affected many agents used in NICUs, which can have quality and safety implications for patient care, especially in extremely low birth weight infants. Neonatologists must be aware of current shortages and implement mitigation strategies to optimize patient care.
在过去的二十年中，处方药物短缺的情况显著增加，这也影响了重症监护和儿科领域的药物。
分析影响新生儿重症监护病房（NICU）用药的药物短缺情况。
从 2001 年至 2016 年，我们从犹他大学药物信息服务处获取了前 100 种 NICU 药物的药物短缺数据。我们主要分析了药物类别、剂型、短缺原因和短缺持续时间。
前 100 种 NICU 药物中有 74 种受到 227 次短缺的影响（占总短缺的 10.3%）。截至 2016 年 12 月，仍有 28 次（12.3%）短缺未得到解决。已解决的短缺持续时间中位数为 8.8 个月（四分位距为 3.6-21.3），其中涉及 175 种（87.9%）通用药物。有 171 种（85.8%）药物有替代药物，但 120 种（70.2%）替代药物也受到短缺的影响。涉及 172 种（86.4%）的肠外药物短缺，持续时间长于非肠外药物（9.9 与 6.4 个月，p = 0.022）。最常见的短缺原因是生产问题（32.2%）。
药物短缺影响了许多 NICU 中使用的药物，这可能会对患者的治疗质量和安全产生影响，尤其是对极低出生体重儿。新生儿科医生必须了解当前的短缺情况，并实施缓解策略，以优化患者的治疗。
