Survey of the Use of Corticosteroids Among Neonatal Intensive Care Units for the Prevention or Treatment of Bronchopulmonary Dysplasia

OBJECTIVE To survey neonatal intensive care units (NICUs) at academic medical centers to determine the current use of inhaled and systemic corticosteroids for the prevention or treatment of bronchopulmonary dysplasia (BPD).

METHODS A survey was developed to evaluate aspects of systemic and inhaled corticosteroid use in neonates. Eighty academic medical centers with neonatal/perinatal medicine fellowship programs were surveyed. Neonatology fellows or NICU clinical pharmacists with direct patient care activities responded via telephone, fax or e-mail.

RESULTS Fifty-three institutions responded to the survey (66.3% response rate). Twenty-nine percent of respondents (n = 15) use corticosteroids for prevention of BPD. Systemic corticosteroids are used by 6% of respondents (n = 3) and inhaled corticosteroids are used by 14% of respondents (n = 7) for prevention. Ten percent of respondents (n = 5) use either systemic or inhaled corticosteroids for prevention. Eighty-eight percent of respondents (n = 45) use corticosteroids for treatment of BPD. Systemic corticosteroids are used by 10% of respondents (n = 5) and inhaled corticosteroids are used by 10% of respondents (n = 5) for treatment. Sixty-nine percent of respondents (n = 35) use either systemic or inhaled corticosteroids for treatment. There was a wide variability in drug, dose, titration, taper, administration, and duration of therapy reported.

CONCLUSIONS These results indicate that systemic and inhaled corticosteroids are commonly used by practitioners for the prevention or treatment of BPD despite a recommendation against the routine use of systemic corticosteroids by the American Academy of Pediatrics' (AAP) Committee on Fetus and Newborn and the Canadian Paediatric Society's Fetus and Newborn Committee from February 2002.