Background and importance The 1000 bed Donauspital, Vienna, provides all types of care for children, including a paediatric intensive care unit (PICU) and a neonatal intensive care unit (NICU). Pharmacotherapy in paediatrics is often limited because no licensed medication is available for the condition of the child or, if available, the dosage is not correct for age and/or developmental stage. Therefore, individually manufactured medicines play an important role in the therapy of children.
As we had to assess the appropriateness of our allocation of human resources, we conducted this study to find out what amount of manufactured medicines are needed to treat our paediatric patients.
Aim and objectives We investigated the extent of individually manufactured medications for children in our hospital (figure 1). These medications included all types of dosage forms (eg, capsules, suppositories, intravenous preparations and compounded solutions for parenteral nutrition (TPN)) to see if drug therapy in critically ill children can be successful without manufacturing in the pharmacy and to evaluate the significance of pharmacy production.
Material and methods For three months (May to July 2019) all prescriptions for patients in the PICU and NICU were recorded from the critical care information system of the hospital. We compared the number of individually manufactured medications with the number of drugs used that were commercially available. All drugs were counted once per used dosage, even when prescribed several times for the same patient. We also counted TPN only once per patient (one solution containing amino acids, electrolytes and trace elements and one lipid emulsion containing vitamins), although the amount of the components prescribed changed almost daily.
Results During our study period in both the PICU and NICU, 99 children were hospitalised and treated with 1286 medications, of which 225 were pharmacy manufactured (17.5%).
Conclusion and relevance A Pub-Med search found studies dealing with the problem of unlicensed or off-label drugs in children, but no data were found evaluating the amount that is manufactured in the pharmacy. Our findings showed that individual pharmacy preparation in paediatrics is indispensable for the success of pharmacotherapy in critically ill children. It means that conditions were treatable that otherwise were not.
References and/or acknowledgements No conflict of interest.
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