• Julia A Heneghan, Eduardo A Trujillo Rivera, Qing Zeng-Treitler, Farhana Faruqe, Hiroki Morizono, James E Bost, Murray M Pollack, and Anita K Patel.
• Division of Critical Care Medicine, Department of Pediatrics, Children's National Health System and George Washington University School of Medicine and Health Sciences, Washington, DC.
• Pediatr Crit Care Me. 2020 Sep 1; 21 (9): e679-e685.

ObjectiveTo examine medication administration records through electronic health record data to provide a broad description of the pharmaceutical exposure of critically ill children.DesignRetrospective cohort study using the Cerner Health Facts database.SettingUnited States.PatientsA total of 43,374 children 7 days old to less than 22 years old receiving intensive care with available pharmacy data.InterventionsNone.Measurements And Main ResultsA total of 907,440 courses of 1,080 unique medications were prescribed with a median of nine medications (range, 1-99; 25-75th percentile, 5-16) per patient. The most common medications were acetaminophen, ondansetron, and morphine. Only 45 medications (4.2%) were prescribed to more than 5% of patients, and these accounted for 442,067 (48.7%) of the total courses of medications. Each additional medication was associated with increased univariate risk of mortality (odds ratio, 1.05; 95% CI, 1.05-1.06; p < 0.001).ConclusionsChildren receiving intensive care receive a median of nine medications per patient and one quarter are prescribed at least than 16 medications. Only 45 medications were prescribed to more than 5% of patients, but these accounted for almost half of all medication courses.

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