Amer J Perinatol 2018; 35(05): 486-493
DOI: 10.1055/s-0037-1608708
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Perianal Dermatitis, Its Incidence, and Patterns of Topical Therapies in a Level IV Neonatal Intensive Care Unit

Anuj Malik
Department of Pediatrics, West Virginia University School of Medicine, Morgantown, West Virginia
Regional Intensive Care Nursery, Conemaugh Memorial Medical Center, Johnstown, Pennsylvania
,
Emily Witsberger
Department of Pediatrics, West Virginia University School of Medicine, Morgantown, West Virginia
,
Lesley Cottrell
Department of Pediatrics, West Virginia University School of Medicine, Morgantown, West Virginia
,
Autumn Kiefer
Department of Pediatrics, West Virginia University School of Medicine, Morgantown, West Virginia
,
Panitan Yossuck
Department of Pediatrics, West Virginia University School of Medicine, Morgantown, West Virginia
› Author Affiliations
Further Information

Publication History

04 July 2017

09 October 2017

Publication Date:
22 November 2017 (eFirst)

Abstract

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.