Malik A, Witsberger E, Cottrell L, Kiefer A, Yossuck P, et al.
American journal of perinatology. Date of publication 2018 Apr 1;volume 35(5):486-493.
1. Am J Perinatol. 2018 Apr;35(5):486-493. doi: 10.1055/s-0037-1608708. Epub 2017
Nov 22.
Perianal Dermatitis, Its Incidence, and Patterns of Topical Therapies in a Level
IV Neonatal Intensive Care Unit.
Malik A(1)(2), Witsberger E(1), Cottrell L(1), Kiefer A(1), Yossuck P(1).
Author information:
(1)Department of Pediatrics, West Virginia University School of Medicine,
Morgantown, West Virginia.
(2)Regional Intensive Care Nursery, Conemaugh Memorial Medical Center,
Johnstown, Pennsylvania.
OBJECTIVE: To define the incidence of perianal dermatitis (PD) and determine
the usage pattern and cost efficacy of diaper products among neonates admitted
to a level IV neonatal intensive care unit (NICU) including those with a
diagnosis of neonatal abstinence syndrome (NAS).
METHODS: A retrospective cohort study to evaluate neonates with PD based on
number of orders for Aquaphor, Bagbalm, Desitin, Flanders, or Nystatin. Various
demographic and clinical parameters were recorded. Usage patterns of these five
products were analyzed, and their costs estimated. Subgroup analysis was
performed among infants with NAS.
RESULTS: Of 1,241 admissions, 56.2% had at least one diaper product ordered
during their NICU stay, while 52.6% had multiple products ordered. Only 23.0% of
all neonates had appropriate documentation of PD. The most common product
ordered first was Aquaphor (64.3%), followed by Desitin (19.2%). Note that 86%
term NAS infants had PD compared with 28% term non-NAS infants. The estimated
product cost was $14,139 over 2 years, averaging $20 per patient.
CONCLUSION: Over half of NICU neonates were exposed to one or more diaper
products, usually without documented PD diagnosis. Term NAS infants had three
times higher incidence of PD than term non-NAS infants. The cost of diaper
product use was significant, and possibly underestimated due to lack of
documentation.
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
DOI: 10.1055/s-0037-1608708
PMID: 29166675 [Indexed for MEDLINE]
Conflict of interest statement: Disclosure The authors report no conflicts of
interest in this work.
