title: Patterns of medication administration from 2001 to 2009 in the treatment of children with acute burn injuries: a multicenter study.
abstract: Children with burn injuries receive a broad range of medications, from analgesics to antipsychotics, but how utilization of these drugs differs from one pediatric burn center to another is unclear. This study examined utilization patterns of six categories of medication administered acutely to burned children as a first step in creating evidence-based practice guidelines. Six medications administered to pediatric patients enrolled in a multicenter study were recorded from patient charts using a standardized chart review template. The medication categories included opiates, benzodiazepines, antidepressants, beta-blockers, two different anesthetics, and antipsychotics. Data were analyzed by χ and logistical regression analysis. Analysis of data from three sites and 470 patients revealed significant differences in prescription patterns across hospitals for all medication groups except opiates. Differences were significant for benzodiazepines and antidepressants (χ = 7.3; P < .01 for both) controlling for age, gender, race, language, burn size, and length of stay. Differences in prescribing patterns for beta-blockers and the anesthetics ketamine and propofol failed to reach statistical significance; however, the results did trend in that direction (χ = 3.8 and 3.4, respectively; P < .10 for both). The pharmacotherapeutic agents described in this study are an integral part of acute pediatric burn care, and yet there is variation in use of these medications among the centers. The differences in prescribing indicate that, for certain drugs, a range of approaches to pharmacotherapeutics is being used and suggest that evidence-based guidelines for administration of these agents need to be developed.
authors.affiliation: Shriners Hospitals for Children-Boston, Massachusetts, USA.
authors.forename: Frederick J
authors.initials: FJ
authors.lastname: Stoddard
authors.forename: Gwyne W
authors.initials: GW
authors.lastname: White
authors.forename: Lewis E
authors.initials: LE
authors.lastname: Kazis
authors.forename: J Michael
authors.initials: JM
authors.lastname: Murphy
authors.forename: Erica A
authors.initials: EA
authors.lastname: Sorrentino
authors.forename: Michelle
authors.initials: M
authors.lastname: Hinson
authors.forename: Teresa
authors.initials: T
authors.lastname: Kim Stubbs
authors.forename: Grace
authors.initials: G
authors.lastname: Chan
authors.forename: Robert L
authors.initials: RL
authors.lastname: Sheridan
authors.forename: Tina
authors.initials: T
authors.lastname: Palmieri
authors.forename: Richard
authors.initials: R
authors.lastname: Kagan
authors.forename: David
authors.initials: D
authors.lastname: Herndon
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Tompkins
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D058647:Adrenergic alpha-2 Receptor Agonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000700:Analgesics / Q000627:therapeutic use; D000777:Anesthetics / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D002053:Burn Units / Q000706:statistics & numerical data*; D002056:Burns / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006748:Hospital Departments / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D010372:Pediatrics / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000706:statistics & numerical data*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D000319:Adrenergic beta-Antagonists; D000700:Analgesics; D000777:Anesthetics; D001569:Benzodiazepines