Drug utilization study in a neonatology unit of a tertiary care hospital in eastern India

Abstract

To evaluate the drug prescribing trends in a neonatal intensive care unit (NICU) of a tertiary care hospital in eastern India. The study was a prospective study that spanned for a period of 6 months from March 2005 to August 2005. Prescriptions and patient records were reviewed and analyzed using the World Health Organization (WHO) indicators for drug utilization studies. Rationality of drug usage was also evaluated by analyzing the drug prescriptions. A total of 176 neonates were admitted and 21 deaths were noted. The total number of drugs prescribed were 849. The average number of drugs per prescription was 4.8. The intravenous route (92.1%) was the commonest route of drug administration. 79.7% of the drugs were prescribed in generics. 30.2% of the total drugs prescribed were antimicrobials. It was noted that 88.6% of the drugs prescribed were in compliance with the National list of Essential Medicines 2003. The common diseases for which the neonates sought admission in the NICU were suspected septicaemia, birth asphyxia, neonatal jaundice and major congenital malformations. As antibiotics were the most frequently used drugs, their usage was analyzed in all cases. It was found to be rational in 84% of suspected septicaemia cases, as the provisional diagnosis on admission was confirmed with subsequent investigations thereby justifying appropriate antibiotic therapy. The diagnosis and treatment of other cases like neonatal jaundice, birth asphyxia, congenital malformations and electrolyte imbalance were rational and treatment was given as per treatment guidelines. Irrational usage of vitamins, nutritional supplements and parenteral fluids was not noted. The absence of the latest National essential list of medicines at the neonatology unit was noted. Secondly an antibiotic usage policy for the unit depending on the local microbial sensitivity pattern should have been in place.