Benzyl Alcohol in Neuromuscular Blocking Agents

In Reply.— The comments of van der Hal et al serve to further underscore our concerns regarding the uncritical appropriation for use in neonates of pharmacologic agents belonging to the "adult" formulary. The issue is pervasive—the overwhelming preponderance of drugs used in neonatal intensive care settings are the adopted progeny of research into adult pathophysiology. Following our initial identification of the risk of benzyl alcohol toxicity associated with continuous infusions of doxapram (Pediatrics 1986;78:540-541), we subjected to close scrutiny the formulation of all agents administered iv in our nursery.