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- Title
Younger Children with Respiratory Tract Infections Are More Exposed to Off-Label Treatments: An Exploratory Retrospective Study in a Pediatric Emergency Setting.
- Authors
Venckute, Greta; Zekaite-Vaisniene, Erika; Oniunaite, Urte; Jankauskaite, Lina
- Abstract
Off-label drug use is prevalent in the pediatric population and represents a patient safety concern. We aimed to identify factors for off-label drug use in our pediatric emergency department (PED). Methods. We performed a retrospective data analysis. All patients aged 0–18 referred to PED from 1 September to 1 October 2022, were included. Further analysis was performed when respiratory tract infections were diagnosed. Data collected: gender, age, triage group, chronic diseases, vital signs, and PED-prescribed treatment (medications, dosages, methods of administration). Statistical analysis used SPSS 28.0, with significance at p < 0.05. Results. Data from 473 patients were analyzed, median age 3.5 years. Chronic diseases were present in 17.1% of children. 387 medications were prescribed, 47.5% being off-label. Off-label treatment was common for external otitis, acute laryngitis, and acute bronchitis (p < 0.001). There was incorrect administration of tobramycin with dexamethasone for otitis (n = 16, 100%) and inappropriate use of salbutamol inhalations by age (34.8%, n = 16). Some medications were given orally instead of injections (ondansetron n = 5, 62.5%; dexamethasone n = 82, 98.7%) or intranasally instead of intravenously (IV) (midazolam n = 7, 87.5%). IV adrenalin was prescribed for inhalations (n = 46). Younger children were more likely to receive off-label treatment (p < 0.001). Conclusion. Our study highlights the widespread issue of off-label and unlicensed drug prescribing in pediatric emergency care. Further research is necessary, because this reliance on off-label prescribing raises concerns about patient safety and compliance, especially given the limited clinical trials and therapeutic options available.
- Subjects
LITHUANIA; OFF-label use (Drugs); VITAL signs; DRUG administration routes; ONDANSETRON; PEARSON correlation (Statistics); INAPPROPRIATE prescribing (Medicine); RESPIRATORY infections; INTRANASAL administration; PATIENT safety; T-test (Statistics); MEDICATION errors; SEX distribution; LOGISTIC regression analysis; HOSPITAL emergency services; RETROSPECTIVE studies; AGE distribution; LARYNGITIS; BRONCHITIS; MIDAZOLAM; ADRENALINE; DESCRIPTIVE statistics; MANN Whitney U Test; CHI-squared test; PEDIATRICS; CHRONIC diseases; TOBRAMYCIN; INHALATION administration; PHYSICIAN practice patterns; RESEARCH; DRUG prescribing; DATA analysis software; ALBUTEROL; CONFIDENCE intervals; MEDICAL triage; OTITIS externa; DEXAMETHASONE; INTRAVENOUS injections
- Publication
Children, 2024, Vol 11, Issue 6, p735
- ISSN
2227-9067
- Publication type
Article
- DOI
10.3390/children11060735