RT journal article
T1 Ototoxic and Nephrotoxic Drugs in Neonatal Intensive Care Units: Results of a Spanish and Italian Survey
A1 Arribas, Cristina
A1 Decembrino, Nunzia
A1 Raffaeli, Genny
A1 Amodeo, Ilaria
A1 González Caballero, Juan Luis
A1 Riaza, Mónica
A1 Ortiz Movilla, Roberto
A1 Massenzi, Luca
A1 Gizzi, Camilla
A1 Araimo, Gabriella
A1 Cattarelli, Donatella
A1 Aversa, Salvatore
A1 Martinelli, Stefano
A1 Frezza, Simonetta
A1 Orfeo, Luigi
A1 Mosca, Fabio
A1 Cavallaro, Giacomo
A1 Garrido Martínez de Salazar, Felipe
A2 Estadística e Investigación Operativa
A2 Materno-Infantil y Radiología
K1 ototoxicity
K1 nephrotoxicity
K1 neonates
K1 pharmacodynamics
K1 hearing impairment
K1 acute kidney injury
AB Background. Neonates face heightened susceptibility to drug toxicity, often exposed to off-labelmedications with dosages extrapolated from adult or pediatric studies. Premature infants in NeonatalIntensive Care Units (NICUs) are particularly at risk due to underdeveloped pharmacokinetics andexposure to multiple drugs. The study aimed to survey commonly used medications with a higher risk ofototoxicity and nephrotoxicity in Spanish and Italian NICUs.Methods. A prospective cross-sectional study was conducted in Italian and Spanish NICUs using a webbased survey with 43 questions. A modified Delphi method involved experts refining the survey throughonline consensus. Ethical approval was obtained, and responses were collected from January to July2023. The survey covered various aspects, including drug-related ototoxic and nephrotoxic management,hearing screening, and therapeutic drug monitoring.Results. Responses from 131 participants (35.9% from Spain and 64.1% from Italy) revealed awarenessof drug toxicity risks. Varied practices were observed in hearing screening protocols, and a highprevalence of ototoxic and nephrotoxic drug use, including aminoglycosides (100%), vancomycin(70.2%), loop diuretics (63.4%), and ibuprofen (62.6%). Discrepancies existed in guideline availability andadherence, with differences between Italy and Spain in therapeutic drug monitoring practices.Conclusions. The study underscores the need for clinical guidelines and uniform practices in managingototoxic and nephrotoxic drugs in NICUs. Awareness is high, but inconsistencies in practices indicate anecessity for standardization, including the implementation of therapeutic drug monitoring and theinvolvement of clinical pharmacologists. Addressing these issues is crucial for optimizing neonatal carein Southern Europe.
PB Springer Science and Business Media Deutschland GmbH
SN 1432-1076
YR 2024
FD 2024
LK http://hdl.handle.net/10498/33644
UL http://hdl.handle.net/10498/33644
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 10-nov-2026