Trends in Medication Use in Very Low-Birth-Weight Infants in a Level 3 NICU over 2 Decades

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This study aims to study the association between trends in medication utilization and survival in very low-birth-weight (VLBW) infants over a 22-year period.

Study Design

Medications received by VLBW infants were extracted retrospectively for the four periods 1990 to 1994, 1995 to 2000, 2001 to 2005, and 2006 to 2011 from our perinatal database and stratified by two birth weight groups: ≤ 1,000 g and 1,001 to 1,500 g.


A total of 5,529 VLBW infants were reviewed. The majority of them were African American (78%), with an increasing proportion over time. The median number of medications per patient in all VLBW infants remained similar over time, 9 (5, 15). A cardiovascular group of medications was most commonly used, with a significant increase in the use of dobutamine and indomethacin. A significant trend toward an increasing number of infants without any antibiotic exposure was also noted. Survival steadily and significantly increased from 83 to 87%.


The trends of overall medication use remained the same in our neonatal intensive care unit (NICU) over the past 22 years. There was no association between medication utilization and survival. VLBW infants continue to receive a high number of medications in the NICU, including a variety of antibiotics.

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