Medications for children receiving intensive care: A national sample

Document Type

Journal Article

Publication Date

1-1-2020

Journal

Pediatric Critical Care Medicine

DOI

10.1097/PCC.0000000000002391

Keywords

critical care; medication; pediatrics; pharmacology; prescription

Abstract

© 2020 Lippincott Williams and Wilkins. All rights reserved. Objective: To examine medication administration records through electronic health record data to provide a broad description of the pharmaceutical exposure of critically ill children. Design: Retrospective cohort study using the Cerner Health Facts database. Setting: United States. Patients: A total of 43,374 children 7 days old to less than 22 years old receiving intensive care with available pharmacy data. Interventions: None. Measurements and Main Results: A total of 907,440 courses of 1,080 unique medications were prescribed with a median of nine medications (range, 1-99; 25-75th percentile, 5-16) per patient. The most common medications were acetaminophen, ondansetron, and morphine. Only 45 medications (4.2%) were prescribed to more than 5% of patients, and these accounted for 442,067 (48.7%) of the total courses of medications. Each additional medication was associated with increased univariate risk of mortality (odds ratio, 1.05; 95% CI, 1.05-1.06; p < 0.001). Conclusions: Children receiving intensive care receive a median of nine medications per patient and one quarter are prescribed at least than 16 medications. Only 45 medications were prescribed to more than 5% of patients, but these accounted for almost half of all medication courses.

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