Drug utilisation in preterm and term neonates.

Drug utilisation in term and preterm neonates (i.e. less than 28 days of age) has been investigated prospectively in 4 clinical studies during the past 10 years. 3880 neonates with a mean gestational age of 34.5 weeks (corresponding birthweight 2280g) were enrolled in these studies. An overview indicates a high prevalence of antibiotic treatment throughout the studies, ranging from 69% to virtually 100%. The highest prevalence was observed in studies enrolling only preterm neonates (gestational age less than 30 weeks) with need for mechanical ventilation. A further high prevalence of parenteral nutrition (84 to 100%), transfusion of blood products (91 to 100%) and vitamin use (16 to 78%) was described. Higher degrees of immaturity and rates of complications were associated with an increased drug usage up to a mean of 17 different drugs in very preterm (i.e. less than or equal to 30 weeks gestation) neonates with severe respiratory disorders and related complications. The high prevalence of antibiotic usage may be explained by the fact that clinical symptoms of neonatal bacterial infections are usually variable, and laboratory tests initially are not highly specific. Respiratory disorders in neonates are often associated with or caused by infections. Nosocomial infections in neonatal intensive care units further prompt administration of antimicrobial agents. Six prospective controlled clinical trials during the past 10 years have investigated treatment with dexamethasone of bronchopulmonary dysplasia, a chronic lung disease secondary to mechanical ventilation of surfactant-deficient lungs in very preterm neonates.(ABSTRACT TRUNCATED AT 250 WORDS)