Polypharmacy Among Hospitalized Pediatric Cancer Patients

BACKGROUND: Very little information exists on the degree of polypharmacy among hospitalized children.Pediatric patients being treated for suspected or confirmed bacterial infections with IV antibiotics represent a complex patient population where drug exposure from multiple agents is known to be high and the risk of drug-drug interactions poorly understood. The objective of this study was to determine the drug exposure per hospitalization among pediatric cancer patients receiving IV vancomycin or meropenem antibiotic therapy. METHODS:Complete co-medication data was not available until after September 8, 2014, and were analyzed in November 2014. Patients ≤ years of age hospitalized at one or more of 22 hospitals located in the Intermountain West receiving ≤ 2 does of IV vancomycin or meropenem for the complete years of 2006 to 2012 were retrospectively evaluated using an EMR database. IV fluids, parenteral nutrition, vitamins, and heparin were excluded. Cancer diagnoses were derived from a validated hospital registry. Statistical analyses were performed in Prism 6 (GraphPad) and R. RESULTS: There wer 294 patients with cancer and 5834 patients without cancer representing 7749 total hospitalizations over the study period. Patients with cancer received more drugs per hospitalizations (median, IQR; 20, 10-37) compared to non-caner patients (16,8-29; p\u3c0.0001). The overall top ten ranked medications used in patients with cancer (which differed from those without cancer) by does volume, expereinced a year-to-year trend (p\u3c0.0001) toward fewer doses per patient. CONCLUSION: Over the study period, cancer patients were exposed to more drugs per hospitalization than their counterparts without cancer. However, among the most frequently use agents in cancer patients, there was a consistent pattern of fewer doses being administered over time