Division of Graduate Entry Medicine, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK.
Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK.
Int J Environ Res Public Health. 2020 Aug 5;17(16):5669. doi: 10.3390/ijerph17165669.
Rational prescribing is challenging in neonatology. Drug utilization studies help identify and define the problem. We performed a review of the literature on drug use in neonatal units and describe global variations. We searched databases (EMBASE, CINAHL and Medline) from inception to July 2020, screened studies and extracted relevant data (two reviewers). The search revealed 573 studies of which 84 were included. India (n = 14) and the USA (n = 13) reported the most. Data collection was prospective (n = 56) and retrospective (n = 26), mostly (n = 52) from one center only. Sixty studies described general drug use in 34 to 450,386 infants (median (IQR) 190 (91-767)) over a median (IQR) of 6 (3-18) months. Of the participants, 20-87% were preterm. The mean number of drugs per infant (range 11.1 to 1.7, pooled mean (SD) 4 (2.4)) was high with some reporting very high burden (≥30 drugs per infant in 8 studies). This was not associated with the proportion of preterm infants included. Antibiotics were the most frequently used drug. Drug use patterns were generally uniform with some variation in antibiotic use and more use of phenobarbitone in Asia. This study provides a global perspective on drug utilization in neonates and highlights the need for better quality information to assess rational prescribing.
在新生儿学中，合理用药具有挑战性。药物利用研究有助于识别和定义问题。我们对新生儿病房药物使用的文献进行了综述，并描述了全球差异。我们从创建到 2020 年 7 月在数据库（EMBASE、CINAHL 和 Medline）中进行了检索，筛选研究并提取相关数据（两名评审员）。检索结果显示有 573 项研究，其中 84 项被纳入。印度（n = 14）和美国（n = 13）报告的最多。数据收集前瞻性（n = 56）和回顾性（n = 26），大部分（n = 52）仅来自一个中心。60 项研究描述了 34 至 450386 名婴儿（中位数（IQR）190（91-767））的一般药物使用情况，中位数（IQR）为 6（3-18）个月。参与者中，20-87%为早产儿。每名婴儿的平均用药数（范围 11.1 至 1.7， pooled mean (SD) 4 (2.4)）较高，其中 8 项研究报告了非常高的负担（≥30 种药物/婴儿）。这与纳入的早产儿比例无关。抗生素是最常用的药物。药物使用模式通常是一致的，但抗生素的使用存在一些差异，亚洲地区更常使用苯巴比妥。本研究提供了新生儿药物利用的全球视角，并强调需要更好的质量信息来评估合理用药。
