Olivia Williams1, Anne Greenough. 1. Children Nationwide Regional Neonatal Intensive Care Unit, Department of Child Health, Kings College Hospital, SE5 9RS London, UK.
Abstract
UNLABELLED: Corticosteroids given systemically in the first 2 weeks after birth may reduce chronic lung disease (CLD) and mortality, but there are concerns regarding the long-term adverse effects which may have influenced prescribing habits. The aim of this study was to determine whether corticosteroids were still prescribed and, if so, was there a consensus regarding the most appropriate regimen to use. Consultant paediatricians at all 223 neonatal units in the United Kingdom were sent a questionnaire asking which route, timing, dosage and indications they used when administering corticosteroids. There was a 72% response rate to the survey. Of those who responded, 33% never prescribed steroids and 3.75% gave inhaled steroids only. Corticosteroids were not prescribed in the 1st week after birth, 21.1% of respondents commenced administration in the 2nd week and 33.3% only outside the neonatal period. A total of 48% prescribed a daily dose of 0.5 mg/kg per day, 33% gave lower doses, with 7.9% prescribing 0.1 mg/kg per day or less. The majority (77%) prescribed corticosteroids only to ventilator-dependent infants, others also gave corticosteroids to chronically continuous positive airway pressure- or oxygen-dependent infants. CONCLUSION: There are wide variations in corticosteroid usage. This emphasises the need to identify if there is a corticosteroid dosage regimen with a positive risk/benefit ratio.
UNLABELLED: Corticosteroids given systemically in the first 2 weeks after birth may reduce chronic lung disease (CLD) and mortality, but there are concerns regarding the long-term adverse effects which may have influenced prescribing habits. The aim of this study was to determine whether corticosteroids were still prescribed and, if so, was there a consensus regarding the most appropriate regimen to use. Consultant paediatricians at all 223 neonatal units in the United Kingdom were sent a questionnaire asking which route, timing, dosage and indications they used when administering corticosteroids. There was a 72% response rate to the survey. Of those who responded, 33% never prescribed steroids and 3.75% gave inhaled steroids only. Corticosteroids were not prescribed in the 1st week after birth, 21.1% of respondents commenced administration in the 2nd week and 33.3% only outside the neonatal period. A total of 48% prescribed a daily dose of 0.5 mg/kg per day, 33% gave lower doses, with 7.9% prescribing 0.1 mg/kg per day or less. The majority (77%) prescribed corticosteroids only to ventilator-dependent infants, others also gave corticosteroids to chronically continuous positive airway pressure- or oxygen-dependent infants. CONCLUSION: There are wide variations in corticosteroid usage. This emphasises the need to identify if there is a corticosteroid dosage regimen with a positive risk/benefit ratio.
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