Awoke Mengist, Melaku Tsegaye, Beshir Mohammed
Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, PO. Box 378, Jimma, Ethiopia.
Department of Pediatrics, Jimma University Medical Center, PO. Box 378, Jimma, Ethiopia.
J Pharm Health Care Sci. 2021 Jun 1;7(1):20. doi: 10.1186/s40780-021-00203-0.
Neonatal populations are quite susceptible to drug-related problems (DRPs) because of clinical heterogeneity and clinical practice trends. However, studies reporting DRPs in the neonatal population are quite limited.
This study aimed to assess the magnitude and types of DRPs and determinant factors among neonates admitted with neonatal sepsis at the Neonatal Intensive Care Unit (NICU) of the Jimma University Medical Center (JUMC), Ethiopia.
A hospital-based prospective observational study was conducted involving 201 neonates with sepsis admitted to the NICU from May to August 30, 2018. DRPs were classified using Cipolle's classification method. Statistical Package for Social Science Version 22 was employed for data analysis. Logistical regression was carried out to determine the determinants of DRPs. A p-value < 0.05 was considered to be statistically significant.
Of 201 neonates with sepsis included in this study, 125 (62.2%) were males and the median age of the neonate was 5 days. The mean (±standard deviation) number of medications taking during their hospital stay was 2.6 ± 0.7. DRPs were identified in 98 neonates, at a rate of 48.8% (95% CI, 41.7-55.9). Dose too high (42, 35.8%) and need additional drug therapy (40, 34.1%) were the commonly identified DRPs. Taking antibiotics plus other medications (Adjusted Odds Ratio (AOR) =5.2, 95%CI [1.2-22.0], p = 0.02) was a determinant factor for the occurrence of DRPs.
The burdens of DRPs occurrence were high in hospitalized neonates with sepsis. The most common DRPs identified were dose too high and need additional drug therapy. Combined use of other medicines with antibiotics was a predictor of DRP occurrence. The innovative way to tackle the occurrence of DRPs, such as the incorporation of clinical pharmacy service provider into the neonatal care team, which will prevent, detect and/or minimize the occurrence of DRPs, is highly recommended.
由于临床异质性和临床实践趋势，新生儿群体极易出现药物相关问题（DRPs）。然而，报道新生儿群体中DRPs的研究相当有限。
本研究旨在评估埃塞俄比亚吉马大学医学中心（JUMC）新生儿重症监护病房（NICU）收治的新生儿败血症患儿中DRPs的严重程度、类型及决定因素。
进行了一项基于医院的前瞻性观察研究，纳入2018年5月至8月30日入住NICU的201例败血症新生儿。采用西波勒分类法对DRPs进行分类。使用社会科学统计软件包第22版进行数据分析。进行逻辑回归以确定DRPs的决定因素。p值<0.05被认为具有统计学意义。
本研究纳入的201例败血症新生儿中，125例（62.2%）为男性，新生儿中位年龄为5天。住院期间平均（±标准差）用药数量为2.6±0.7种。98例新生儿被确定存在DRPs，发生率为48.8%（95%CI，41.7 - 55.9）。剂量过高（42例，35.8%）和需要额外药物治疗（40例，34.1%）是常见的DRPs。同时使用抗生素和其他药物（调整优势比（AOR）=5.2，95%CI[1.2 - 22.0]，p = 0.02）是DRPs发生的一个决定因素。
住院败血症新生儿中DRPs的发生负担较高。确定的最常见DRPs是剂量过高和需要额外药物治疗。抗生素与其他药物联合使用是DRP发生的一个预测因素。强烈建议采用创新方法应对DRPs的发生，例如将临床药学服务提供者纳入新生儿护理团队，这将预防、检测和/或减少DRPs的发生。
