Assessment of Neonatal Drug Prescribing Practices in a Special Care Baby Unit in Uyo, Akwa Ibom State, South South Nigeria

Background: Neonates represent a pharmacologically vulnerable population due to immature organ systems, limited pharmacokinetic data, and the frequent need for off-label drug use. Rational prescribing in neonatal units is therefore a critical patient safety priority. This study assessed neonatal drug prescribing practices in the Special Care Baby Unit (SCBU) of University of Uyo Teaching Hospital, Akwa Ibom State. Methods: A three-month prospective observational study reviewed 180 neonatal prescription charts. Variables assessed included drug selection, dosing accuracy against standard neonatal formularies, frequency of off-label prescribing, and documentation quality. Results: A total of 1,140 drug orders were reviewed. Off-label prescribing accounted for 43 percent of orders, predominantly involving antibiotics and analgesics. Dosing errors were identified in 11 percent of drug orders. Gentamicin and ampicillin were the most frequently prescribed antibiotics. Documentation errors including missing weights and incomplete prescriptions were noted in 28 percent of charts. Conclusion: Neonatal prescribing in Uyo SCBU demonstrates notable off-label use and dosing inaccuracies. Implementation of neonatal prescribing guidelines and clinical pharmacist input in ward rounds are recommended. Keywords: neonatal prescribing, off-label drug use, SCBU, Uyo, dosing accuracy