Drug-drug interactions in neonatal intensive care: A prospective cohort study
Drug-drug interactions in neonatal intensive care: A prospective cohort study
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DOI：
10.1016/j.pedneo.2020.10.006
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发表时间：
2021-03-03
影响因子：
2.1
通讯作者：
Martins, Rand Randall
中科院分区：
文献类型：
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作者：
Costa, Haline Tereza;Leopoldino, Ramon Weyler Duarte;Martins, Rand Randall
背景：了解新生儿重症监护病房(NICU)中与主要药物相互作用(DDIS)最相关的药物及其处方的危险因素，以了解药物-药物相互作用(DDIS)的发生率和概况。方法：在NICU住院的新生儿，至少开过一种药物，住院时间为24小时，纳入前瞻性队列研究(2017年8月至2018年7月)。所有住院期间开出的药物均来自所有新生儿(N Z 220)，并进行DDIS筛查。确定DDIS的患病率和类型。用网络分析的方法确定与DDIS有较大关联的药物。对危险因素进行Logistic回归分析(p<；0.05)。结果：超过70%的新生儿暴露于DDIS，29%的新生儿暴露于主要的DDIS。网络分析表明，速尿、芬太尼、氨茶碱和氟康唑与DDI关系最密切，芬太尼尤其与主要DDIS相关。用药次数(OR 1.60，p<；0.01)、剖宫产(OR 2.68，p<；0.05)、胎龄(OR 1.03，p<；0.01)和APGAR评分(OR 0.78，p<；0.01)是DDI发生的危险因素。结论：重症监护室新生儿暴露于DDIS的风险较高，重度DDIS的发生与芬太尼的处方有关。在NICU中，处方药物的数量、胎龄、剖腹产和第一分钟APGAR评分低被确定为DDIS的危险因素。版权所有，2020台湾儿科学会。爱思唯尔台湾有限责任公司出版。这是一篇CC BY-NC-ND许可证(http://creativecommons.org/licenses/BY-NC-ND/4.0/)下的开放获取文章。
Background: To characterize the prevalence and profile of drug-drug interactions (DDIs), the drugs most related to major DDIs and risk factors of their prescription in a neonatal intensive care unit (NICU).Methods: Neonates admitted to a NICU who had at least one medication prescribed and a hospital stay >24 h were included in a prospective cohort study (August 2017 to July 2018). All medications prescribed during the hospitalization were collected from all neonates (n Z 220), with the screening for DDIs. Prevalence and type of DDIs was identified. Network analysis was used to identify the drugs more implicated with DDIs. Logistic regression was used for the analysis of risk factors (p < 0.05).Results: Over 70% of neonates were exposed to DDIs and 29% were exposed to major DDIs. The network analysis identified furosemide, fentanyl, aminophylline and fluconazole as most implicated with DDI, fentanyl was especially associated with major DDIs. The number of drugs (OR 1.60, p < 0.01), caesarean delivery (OR 2.68, p < 0.05), gestational age (OR 1.03, p < 0.01) and APGAR score (OR 0.78, p < 0.01) were identified as risk factors for exposure to DDI.Conclusion: Neonates in intensive care have a high exposure to DDIs and the occurrence of major DDIs is related specifically to the prescription of fentanyl. The number of prescribed drugs, gestational age, cesarean delivery and low APGAR score in the first minute were identified as risk factors for DDIs in NICU.Copyright & ordf; 2020, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).