USE OF OFF-LABEL MEDICATIONS IN A NEONATAL INTENSIVE CARE UNIT
This paper aims to analyze the use of off label (OL) medicines, according to the National Regulatory Agency, in a neonatal intensive care unit of a high-risk maternity hospital in Northeast Brazil. A cross-sectional study was carried out, using a convenience sample of newborns that used mechanical v...
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description | This paper aims to analyze the use of off label (OL) medicines, according to the National Regulatory Agency, in a neonatal intensive care unit of a high-risk maternity hospital in Northeast Brazil.
A cross-sectional study was carried out, using a convenience sample of newborns that used mechanical ventilation at the Intensive Care Unit. As a reference, OL medications were considered for those without an approval for newborn usage by the Brazilian Health Regulatory Agency (Agência Nacional de Vigilância Sanitária - ANVISA) and by the Food and Drugs Administration (FDA).
The sample consisted of 158 newborns, 58.3% male, 87.7% premature, and 70.2% of low or very low birth weight. According to ANVISA, 440 out of the 1,167 prescriptions analyzed were OL, with 98.1% of newborns exposed to at least one of these drugs. According to the FDA, 484 prescriptions were OL, with 75.8% of newborns exposed to at least one of them. Anti-infectives were the most prescribed OL medications. Neonates who presented respiratory failure and pneumonia used these drugs more often; and there was no relation between their use and the number of deaths.
Nearly all newborns at the Intensive Care Units, mainly preterm infants, are exposed to at least one off-label (OL) medication during hospital stay, according to the national and international regulatory agencies. No association was found between off-label prescriptions and the frequency of complications or neonatal deaths. |
doi_str_mv | 10.1590/1984-0462/2021/39/2020063 |
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A cross-sectional study was carried out, using a convenience sample of newborns that used mechanical ventilation at the Intensive Care Unit. As a reference, OL medications were considered for those without an approval for newborn usage by the Brazilian Health Regulatory Agency (Agência Nacional de Vigilância Sanitária - ANVISA) and by the Food and Drugs Administration (FDA).
The sample consisted of 158 newborns, 58.3% male, 87.7% premature, and 70.2% of low or very low birth weight. According to ANVISA, 440 out of the 1,167 prescriptions analyzed were OL, with 98.1% of newborns exposed to at least one of these drugs. According to the FDA, 484 prescriptions were OL, with 75.8% of newborns exposed to at least one of them. Anti-infectives were the most prescribed OL medications. Neonates who presented respiratory failure and pneumonia used these drugs more often; and there was no relation between their use and the number of deaths.
Nearly all newborns at the Intensive Care Units, mainly preterm infants, are exposed to at least one off-label (OL) medication during hospital stay, according to the national and international regulatory agencies. No association was found between off-label prescriptions and the frequency of complications or neonatal deaths.</description><identifier>ISSN: 0103-0582</identifier><identifier>EISSN: 1984-0462</identifier><identifier>DOI: 10.1590/1984-0462/2021/39/2020063</identifier><identifier>PMID: 33440406</identifier><language>eng</language><publisher>Brazil: Sociedade de Pediatria de São Paulo</publisher><subject>Drug utilization ; Infant, newborn ; Intensive Care Units, Neonatal ; Off-label use ; Original</subject><ispartof>Revista Paulista de Pediatria, 2021-01, Vol.39, p.e2020063</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c528t-b0ff09e9a4cc891acae2b882fec3e20207e32545165eae387c26484010963393</citedby><cites>FETCH-LOGICAL-c528t-b0ff09e9a4cc891acae2b882fec3e20207e32545165eae387c26484010963393</cites><orcidid>0000-0002-7125-9349 ; 0000-0002-6228-768X ; 0000-0001-6464-9851 ; 0000-0001-8493-9864</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802993/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802993/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33440406$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Koszma, Erica Inez Alves</creatorcontrib><creatorcontrib>Bispo, Ana Jovina Barreto</creatorcontrib><creatorcontrib>Santana, Isabelle Araujo de Oliveira</creatorcontrib><creatorcontrib>Santos, Catharine Natielle Oliveira Dias Belarmino Dos</creatorcontrib><title>USE OF OFF-LABEL MEDICATIONS IN A NEONATAL INTENSIVE CARE UNIT</title><title>Revista Paulista de Pediatria</title><addtitle>Rev Paul Pediatr</addtitle><description>This paper aims to analyze the use of off label (OL) medicines, according to the National Regulatory Agency, in a neonatal intensive care unit of a high-risk maternity hospital in Northeast Brazil.
A cross-sectional study was carried out, using a convenience sample of newborns that used mechanical ventilation at the Intensive Care Unit. As a reference, OL medications were considered for those without an approval for newborn usage by the Brazilian Health Regulatory Agency (Agência Nacional de Vigilância Sanitária - ANVISA) and by the Food and Drugs Administration (FDA).
The sample consisted of 158 newborns, 58.3% male, 87.7% premature, and 70.2% of low or very low birth weight. According to ANVISA, 440 out of the 1,167 prescriptions analyzed were OL, with 98.1% of newborns exposed to at least one of these drugs. According to the FDA, 484 prescriptions were OL, with 75.8% of newborns exposed to at least one of them. Anti-infectives were the most prescribed OL medications. Neonates who presented respiratory failure and pneumonia used these drugs more often; and there was no relation between their use and the number of deaths.
Nearly all newborns at the Intensive Care Units, mainly preterm infants, are exposed to at least one off-label (OL) medication during hospital stay, according to the national and international regulatory agencies. No association was found between off-label prescriptions and the frequency of complications or neonatal deaths.</description><subject>Drug utilization</subject><subject>Infant, newborn</subject><subject>Intensive Care Units, Neonatal</subject><subject>Off-label use</subject><subject>Original</subject><issn>0103-0582</issn><issn>1984-0462</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNpVke1KwzAUhoMobk5vQeoF1J18tE3-DOrstFA7cJ1_Q5aks2NbpZ2Cd2_q5nAQOCQn75MTHoTuMNzjQMAQC858YCEZEiB4SEVXAUJ6hvrH3jnqAwbqQ8BJD1217crdABxGl6hHKWPAIOyj0XyWeNOJWxM_ix-SzHtJHtNxXKTTfOaluRd7eTLN4yLO3K5I8ln6lnjj-DXx5nlaXKOLUq1be3OoA1RMkmL87GfTJ0fJfB0QvvMXUJYgrFBMay6w0sqSBeektJrabvbIUhKwAIeBVZbySJOQcebmFyGlgg5QuseaWq3kR1NtVPMta1XJ34O6WUrV7Cq9tlK4XxprbBAZw0pLhC0BG220WigTcu1Yoz3r43OxsUbb7a5R6xPoaWdbvctl_SUjDkQI6gBiD9BN3baNLY9ZDLLzIzsHsnMgOz-SCnnw47K3_x8_Jv-E0B8szYZU</recordid><startdate>20210101</startdate><enddate>20210101</enddate><creator>Koszma, Erica Inez Alves</creator><creator>Bispo, Ana Jovina Barreto</creator><creator>Santana, Isabelle Araujo de Oliveira</creator><creator>Santos, Catharine Natielle Oliveira Dias Belarmino Dos</creator><general>Sociedade de Pediatria de São Paulo</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-7125-9349</orcidid><orcidid>https://orcid.org/0000-0002-6228-768X</orcidid><orcidid>https://orcid.org/0000-0001-6464-9851</orcidid><orcidid>https://orcid.org/0000-0001-8493-9864</orcidid></search><sort><creationdate>20210101</creationdate><title>USE OF OFF-LABEL MEDICATIONS IN A NEONATAL INTENSIVE CARE UNIT</title><author>Koszma, Erica Inez Alves ; Bispo, Ana Jovina Barreto ; Santana, Isabelle Araujo de Oliveira ; Santos, Catharine Natielle Oliveira Dias Belarmino Dos</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c528t-b0ff09e9a4cc891acae2b882fec3e20207e32545165eae387c26484010963393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Drug utilization</topic><topic>Infant, newborn</topic><topic>Intensive Care Units, Neonatal</topic><topic>Off-label use</topic><topic>Original</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koszma, Erica Inez Alves</creatorcontrib><creatorcontrib>Bispo, Ana Jovina Barreto</creatorcontrib><creatorcontrib>Santana, Isabelle Araujo de Oliveira</creatorcontrib><creatorcontrib>Santos, Catharine Natielle Oliveira Dias Belarmino Dos</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>Revista Paulista de Pediatria</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koszma, Erica Inez Alves</au><au>Bispo, Ana Jovina Barreto</au><au>Santana, Isabelle Araujo de Oliveira</au><au>Santos, Catharine Natielle Oliveira Dias Belarmino Dos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>USE OF OFF-LABEL MEDICATIONS IN A NEONATAL INTENSIVE CARE UNIT</atitle><jtitle>Revista Paulista de Pediatria</jtitle><addtitle>Rev Paul Pediatr</addtitle><date>2021-01-01</date><risdate>2021</risdate><volume>39</volume><spage>e2020063</spage><pages>e2020063-</pages><issn>0103-0582</issn><eissn>1984-0462</eissn><abstract>This paper aims to analyze the use of off label (OL) medicines, according to the National Regulatory Agency, in a neonatal intensive care unit of a high-risk maternity hospital in Northeast Brazil.
A cross-sectional study was carried out, using a convenience sample of newborns that used mechanical ventilation at the Intensive Care Unit. As a reference, OL medications were considered for those without an approval for newborn usage by the Brazilian Health Regulatory Agency (Agência Nacional de Vigilância Sanitária - ANVISA) and by the Food and Drugs Administration (FDA).
The sample consisted of 158 newborns, 58.3% male, 87.7% premature, and 70.2% of low or very low birth weight. According to ANVISA, 440 out of the 1,167 prescriptions analyzed were OL, with 98.1% of newborns exposed to at least one of these drugs. According to the FDA, 484 prescriptions were OL, with 75.8% of newborns exposed to at least one of them. Anti-infectives were the most prescribed OL medications. Neonates who presented respiratory failure and pneumonia used these drugs more often; and there was no relation between their use and the number of deaths.
Nearly all newborns at the Intensive Care Units, mainly preterm infants, are exposed to at least one off-label (OL) medication during hospital stay, according to the national and international regulatory agencies. No association was found between off-label prescriptions and the frequency of complications or neonatal deaths.</abstract><cop>Brazil</cop><pub>Sociedade de Pediatria de São Paulo</pub><pmid>33440406</pmid><doi>10.1590/1984-0462/2021/39/2020063</doi><orcidid>https://orcid.org/0000-0002-7125-9349</orcidid><orcidid>https://orcid.org/0000-0002-6228-768X</orcidid><orcidid>https://orcid.org/0000-0001-6464-9851</orcidid><orcidid>https://orcid.org/0000-0001-8493-9864</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Drug utilization Infant, newborn Intensive Care Units, Neonatal Off-label use Original |
title | USE OF OFF-LABEL MEDICATIONS IN A NEONATAL INTENSIVE CARE UNIT |
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