Say no to drugs: wait and watch strategy for medications used in the neonatal intensive care unit (NICU)

  • Hilary Tice
  • Shabih ManzarEmail author
  • Nitin Walyat
  • Kelsey Trimble
Personal Viewpoint

From the presentation of gray baby syndrome with chloramphenicol use to gasping baby syndrome with exposure from benzyl alcohol in bacteriostatic flushes, historical clinical precedence has shown that babies cared for in the neonatal intensive care unit (NICU) are at higher risk of adverse effects from medication administration than other populations [1, 2]. Historical precedence led to a discussion amongst the multi-disciplinary team questioning whether medications are used excessively in the NICU. A recent review paper by Hsieh et al. [3] has elaborated on this question in detail, in which a downward trend in the use of certain medications was shown.

The NICU is a very high-risk environment with a higher than normal potential for medication errors to occur. This increased potential for medication errors forms a basis for the importance of instituting safe medication practices in the NICU [4]. Therefore, a vigilant strategy is needed regarding the non-beneficial use of medications in...


Author contributions

HT contributed to design, acquisition and analysis/interpretation of data, and drafting of the article. SM contributed to concept, design, acquisition and analysis/interpretation of data, and drafting of the article. NW contributed to concept, acquisition and analysis/interpretation of data and drafting of the article. KT contributed to analysis/interpretation of data. All the authors revised the article critically and approved the final version to be published.


No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

Compliance with ethical standards

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Conflict of interest

The author(s) declare no conflicts or financial interest in any product or service mentioned in the manuscript, including grants, equipment, medications, employment, gifts, and honoraria.


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Copyright information

© Children's Hospital, Zhejiang University School of Medicine 2019

Authors and Affiliations

  1. 1.University of Louisiana at MonroeShreveportUSA
  2. 2.Division of NeonatologyLouisiana State University Health Sciences ShreveportShreveportUSA
  3. 3.Department of PharmacyOchsner – LSU Health ShreveportShreveportUSA

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