Analysis of Prescribing Patterns in Paediatric Respiratory Tract Infections with the Focus on Antimicrobial Use, Adverse Effects and Cost Of Drug Therapy

Abstract

Aim: To analyze the pharmacological management of respiratory tract infections (RTIs) in paediatric patients. Methodology: A cross-sectional observational study involving 74 patients of paediatric RTI was carried out in a tertiary care teaching hospital. Patients’ demographic and disease related details, drug history, adverse drug reactions, cost of therapy were noted in structured case record form and analysed. Appropriateness of treatment was analysed by comparing with the guidelines set by the WHO and the Indian Academy of Pediatrics (IAP). Results: Out of total 74 patients, 54.05% were in the age group of <1 year and 67.57% were male. The most common diagnosis was pneumonia (48.65%). Average number of drug per patient was 7.25±1.57 (range 3 to 16). Most common drug groups prescribed were antibacterials(100%), analgesic/antipyretics(95.94%) and respiratory drugs(86.49%). Among the antibacterials, amoxicillin+clavulanic acid(90.54%) and ceftriaxone(77.77%) were frequently prescribed. Among respiratory medicines, antihistamines and salbutamol were prescribed to 85.13% and 55.40% of patients respectively. 56.81% drugs prescribed by their generic name and 75% of drugs were prescribed from WHO-EML. Appropriate/rational drug therapy was given to only 13.51% of the patients while drug therapy of rest 35.14% and 51.35% patients was found to be semi-rational and irrational respectively as per the WHO and IAP guidelines. 16.22% patients developed an ADR which was due to antimicrobial or analgesic/antipyretics. Average total drug cost per indoor patient was 314.69 Rs and total antimicrobial cost was calculated as Rs. 286.17. Conclusion: An overuse of antibacterials and respiratory medicines was seen in the study. Emphasis on proper diagnosis and treatment, education and availability of locally effective guidelines may help in a better and judicious use of drugs in paediatric patients.