Evaluation of pharmacotherapy in neonatal and pediatric intensive care unit of a south Indian tertiary care hospital: a prospective observational study

Abstract

Background: Evaluating the pharmacotherapy is essential at neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) to identify and understand pattern and variability in drug use in polypharmacy, also to promote interventions that will improve patient outcomes.Methods: In our study, we audited pharmacotherapy of 300 neonates and 100 pediatric patients admitted to NICU and PICU from November 2018 to February 2019. WHO-CORE prescribing indicators, WHO-ATC system and WHO-ICD 10th version was used to evaluate pharmacotherapy and to understand the pattern and extent of medication use and to systematically classify drugs and diseases respectively.Results: A total of 1207 medications containing 34 unique active ingredients were prescribed for 300 neonates with an average of 4.02 (±2.0) drugs per neonate admitted to NICU and the most prescribed drugs were anti-infectives for systemic use 799. A total of 976 medications containing 69 unique active ingredients were prescribed with an average of 9.76 (±3.81) per pediatric patients admitted to PICU with anti-infectives for systemic use 331 tops the list. More than 75% of drugs was prescribed in generic name with 98% constant availability of key drugs at intensive care unit.Conclusions: This study substantiates the need for reinforcement of institutional antibiotic policies as antibiotics are widely prescribed and there is an increase trend of antibiotic resistance at critical care unit, assessment of WHO core prescribing indicators are reflective of quality care revealing the awareness about strict monitoring of pharmacotherapy.