title: Off-label and unlicensed drug use in neonatal intensive care units in Turkey: the old-inn study.
abstract: BACKGROUND
  Recently several developed countries have improved the safety and efficacy of drugs used in infants and pediatric patients. Most drugs administered to adults have licensed approvals outlining indications, doses, and the recommended route of administration. However, many drugs that are given to children are unlicensed or used off-label.
  
  
  OBJECTIVE
  To assess the extent and nature of unregistered and off-label drug use in neonatal intensive care units (NICUs) in Turkey, and to explore awareness and views of the general public on the unlicensed use of medicine in preterm and term infants in developing countries.
  
  
  METHODS
  A prospective observational study of a dynamic cohort of 464 neonates from 17 NICUs in Turkey. All medications administered to neonates who were hospitalized and admitted to the NICU over a 24-h period were recorded. The prescriptions were analyzed to determine whether the medicines were used in a licensed or unlicensed manner.
  
  
  RESULTS
  In total, 1,315 prescriptions comprising 93 different medicines were written. We found that 62.3% of the drugs prescribed to the neonates over the 24-h period were unlicensed or off-labeled.
  
  
  CONCLUSIONS
  The present study indicates that unlicensed and off-label medicines are frequently used in preterm and term infants in Turkish NICUs. This finding is consistent and reported in other countries. We believe that the needs of the neonatal population must be a priority and access to safe and appropriate medicines requires urgent attention.
authors.affiliation: Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity Teaching Hospital, 06230, Cebeci, Ankara, Turkey.
authors.forename: S Suna
authors.initials: SS
authors.lastname: Oguz
authors.forename: H Gozde
authors.initials: HG
authors.lastname: Kanmaz
authors.forename: Ugur
authors.initials: U
authors.lastname: Dilmen
mesh_terms: D015331:Cohort Studies; D017277:Drug Approval / Q000331:legislation & jurisprudence; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D056687:Off-Label Use / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D055553:Prescription Drugs / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D014421:Turkey
chemical_list: D055553:Prescription Drugs