Drug use in a neonatal unit

All medication administered to patients admitted to a neonatal intensive care unit was registered during a one-year period (1996). Only two (0.4%) of 469 infants admitted were not given any drug at all. A total of 12,019 single doses were administered, a mean of 33 per day. 7,042 (59%) were given orally, and 3,332 (28%) intravenously. 292 (63%) patients were given vitamin K as the only drug. 113 infants (24%) received systemic antibiotic treatment, 5% of all infants born alive at the hospital. Drugs accounted for 2.7% of the total expenses for running the unit. Surfactant (12 single doses) alone accounted for 47% of the costs of drugs. Drug monitoring by serum concentration measurements showed that 32% of the values were outside the therapeutic range. To a limited extent (44%) this was followed by correction of the dose. One single drug dose (1 per 10,000 doses) was administered to a patient for whom the drug was not prescribed. Quality assurance of medication is an important task in neonatal intensive care units.