Leopoldino Ramon Weyler, Costa Haline Tereza, Costa Tatiana Xavier, Martins Rand Randall, Oliveira António Gouveia
Department of Pharmacy, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Av. General Gustavo Cordeiro de Farias, s/n. Petrópolis, Natal, RN, 59012-570, Brazil.
Maternity School Januário Cicco, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Av. Nilo Peçanha, 259. Petrópolis, Natal, RN, 59012-310, Brazil.
BMC Pharmacol Toxicol. 2018 Dec 6;19(1):83. doi: 10.1186/s40360-018-0265-7.
There is little information on the frequency of drug incompatibilities in neonatal intensive care units (NICU) and the agents most commonly involved in them. The objective of the study was to characterize potential Drug Incompatibilities (DI) in the NICU by frequency, type and combination of drugs.
Between August 2015 and December 2016, all neonates admitted for more than 24 h and who received any drug treatment were included in this cohort study conducted in the NICU of a teaching maternity hospital in Brazil. Patient data were collected from patient records and prescription orders, and the compatibilities of all drug pairs were classified using the Trissel's™ 2 IV Compatibility tool. Network analysis was performed in order to visualize the drug pairs commonly involved in potential DI.
The study population consisted of 281 neonates with a median NICU length of stay of 11 days (range 2-184) and received 1343 intravenous medications. A total of 1114 potential DI were identified, 469 (42.1%) were restricted compatibilities, 348 (31.2%) unknown compatibilities and 297 (26.7%) documented incompatibilities. The incidence of documented incompatibilities in the NICU was 25.0% patient-days (95% confidence interval (CI) 19.4-30.7% patient-days). Incompatible potential DI affected 46.3% (95%CI 40.3-52.3%) of the neonates. Ampicillin (408 of 1114 pairs), gentamicin (216 of 1114 pairs) and aminophylline (197 of 1114 pairs) were the main medicines involved in potential DI.
Potential DI are extremely common in NICU, with half of the population susceptible to simultaneous administration of incompatible medications. More research is needed to understand the actual drug incompatibilities and their clinical outcomes.
关于新生儿重症监护病房（NICU）中药物不相容性的发生频率以及最常涉及的药物种类，相关信息较少。本研究的目的是通过药物的频率、类型和组合来描述NICU中潜在的药物不相容性（DI）。
在2015年8月至2016年12月期间，所有入住时间超过24小时且接受任何药物治疗的新生儿均纳入了这项在巴西一家教学妇产医院的NICU进行的队列研究。从患者记录和处方单中收集患者数据，并使用Trissel's™ 2静脉相容性工具对所有药物对的相容性进行分类。进行网络分析以直观显示潜在DI中常见的药物对。
研究人群包括281名新生儿，在NICU的中位住院时间为11天（范围2 - 184天），共接受了1343次静脉用药。总共识别出1114种潜在的DI，其中469种（42.1%）为受限相容性，348种（31.2%）为未知相容性，297种（26.7%）为已记录的不相容性。NICU中已记录的不相容性发生率为25.0%患者日（95%置信区间（CI）19.4 - 30.7%患者日）。不相容的潜在DI影响了46.3%（95%CI 40.3 - 52.3%）的新生儿。氨苄西林（1114对中有408对）、庆大霉素（1114对中有216对）和氨茶碱（1114对中有197对）是潜在DI中涉及的主要药物。
潜在的DI在NICU中极为常见，半数人群易受同时使用不相容药物的影响。需要更多研究来了解实际的药物不相容性及其临床结果。
