Inpatient paediatric use of intravenous immunoglobulin at an academic medical centre.
BACKGROUND
Intravenous immunoglobulin (IVIG) is an important research topic because of its efficacy in the management of an increasing number of diseases, its high cost and limited availability. This study was designed to evaluate the paediatric inpatient use of IVIG and identify strategies to reduce the drug expenditures.


METHODS
Over a six-month period, physician and nursing charts, and notes for subjects who were treated with IVIG, were reviewed to gather the required data. This included patient demographics, IVIG, indications, dosage regimen, adverse drug reactions (ADRs) and their management.


RESULTS
58.3 percent of IVIG infusions were ordered for labelled indications. Patients in the labelled group experienced more clinical improvement than subjects in the off-label group. Haematologists and neurologists were the most prevalent prescribers. ADRs were more prevalent in the off-label group. Hypotension, fever, headache and chills were the most common adverse effects. ADRs were managed with drugs in 22.9 percent of IVIG administrations and IVIG infusions were modified in 12.5 percent of infusions.


CONCLUSIONS
ADRs were more prevalent in this hospital than those reported by other authors. This may be due to nursing negligence of the recommended infusion rate, higher sensitivity of our population or to the brands of IVIG which are used in the hospital. This shows the need for further evaluation of IVIG prescription and administration.
Dashti-Khavidaki
S
S
Department of Clinical Pharmacy (Pharmacotherapy), School of Pharmacy, Tehran University of Medical Sciences, Poursina Ave, PO Box 14155/6451, Tehran 14174, Iran.
Khalili
H
H
Farshadi
F
F
Aghamohammadi
A
A
Movahedi
M
M
Hajibabaei
M
M
D000046:Academic Medical Centers; D002648:Child; D017723:Drug Utilization Review; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008485:Medical Audit; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*
D016756:Immunoglobulins, Intravenous