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Hospitalized children exposed to myriad medications

Feudtner C. Arch Pediatr Adol Med. 2011;doi:10.1001/archpediatrics.2011.161.

Morden N. Arch Pediatric Adol Med. 2011;doi:10.1001/archpediatrics.2011.162.

Despite efforts by federal health officials to reduce overuse of medications in pediatric populations, some hospitalized pediatric patients, particularly those with rare conditions, continue to be exposed to many drugs and therapeutic agents, according to a study and accompanying editorial published online this month.

Chris Feudtner, MD, of The Children’s Hospital of Philadelphia, and colleagues conducted a retrospective study of 2006 data from the Perspective Data Warehouse, which includes data from US academic medical centers, and the Pediatric Health Information System, which includes children’s hospitals in major metropolitan areas in the United States. They looked at the patient’s exposures to medications, as well as other factors such as clinical characteristics and demographics.

The study cohort included 365,868 pediatric patients who experienced 491,451 hospitalizations in 52 children’s hospitals; and 221,559 pediatric patients who experienced 260,740 hospitalizations in 411 general hospitals.

According to the researchers, acetaminophen, albuterol and antibiotics were the medications that children received most.

They also noted fluctuations throughout hospital stays for children, noting that on day 1 in pediatric hospitals, patients aged younger than 1 year received 11 drugs and those aged 1 year and older received 13 drugs. In general hospitals, those aged younger than 1 year received eight drugs and those aged 1 year and older received 12 drugs.

In an accompanying editorial, Nancy E. Morden, MD, and David Goodman, MD, both of the Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Lebanon, N.H., said there were Diagnosis Related Group variations of medication exposure for a number of conditions, including asthma, appendectomy and seizures. They said further data are needed to explore what this means.

“Clinicians, policymakers, researchers and patient advocates should collaborate on efforts aimed at promoting the development of evidence to inform pediatric pharmacotherapy,” they Morden and Goodman wrote. “Moving toward an understanding of the balance of risks and benefits will require better data, a sustained research program, and a commitment to translating new knowledge into better practice.”

Disclosure: The study was funded by the Agency for Healthcare Research and Quality. The researchers report no relevant financial disclosures.

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