Assessment of Neonatal Drug Prescribing in a Special Care Baby Unit in Taraba State

Neonates are among the most pharmacologically vulnerable patient populations, yet drug prescribing in neonatal units in Nigerian public hospitals frequently occurs without dedicated neonatal pharmacotherapy guidelines. This study assessed neonatal drug prescribing practices at the Special Care Baby Unit of a general hospital in Jalingo, Taraba State, North East Nigeria. A retrospective cross-sectional review was conducted on 320 neonatal admission records over a 12-month period. Data extracted included gestational age at birth, birth weight, diagnosis, drugs prescribed, doses, and frequency. Appropriateness of prescribing was evaluated against the British National Formulary for Children and the WHO Model Formulary for neonates. Results showed that a mean of 4.8 drugs were prescribed per neonate. Antibiotics were the most commonly prescribed drug class, used in 84.1 percent of admissions. Off-label and unlicensed prescribing occurred in 41.3 percent of all prescriptions. Dose deviations from recommended neonatal ranges were identified in 27.2 percent of prescriptions, with gentamicin and phenobarbital showing the highest error rates. Weight documentation at admission was absent in 14.1 percent of records, precluding accurate weight-based dosing. The study concludes that neonatal prescribing in this facility is characterised by high rates of off-label use and dosing inaccuracies, and recommends developing a hospital-specific neonatal formulary and deploying a pharmacist with neonatal experience to the Special Care Baby Unit.

Keywords: neonatal prescribing, special care baby unit, off-label drug use, Taraba State, neonatal pharmacotherapy