Health Organization Core Drug Use Research Articles

Prescribing Pattern of Antimicrobial Agents in Patients with Pelvic Inflammatory Disease in a Tertiary Care Hospital at Rural Part of Western Nepal

Introduction: Antibiotics are the most frequently prescribed drugs in patients with Pelvic Inflammatory Diseases. Appropriate antibiotic prescriptions in health care institutions are an important element in quality of care, infection management and cost control.
 Aims: To analyze prescription pattern of antimicrobial agents in patients with pelvic inflammatory diseases.
 Methods: This quantitative cross-sectional study was conducted including 300 patients' prescriptions, at Karnali Academy of Health Sciences Jumla Nepal for period of six months during August 2021 to January 2022. This study was based on medication utilization form, which was designed on basis of World Health Organization core drug use indicator format.
 Results: Females were in ages from 12 to 69 years, with mean of 30.46 ± 18.71 years. Chronic Pelvic inflammatory Disease was most prevalent in 20–29 age group (47%) while, lowest in 60–69 age group (1.67%). The total number of prescribed drugs was 796 averaging 2.65 drugs per prescription. The most commonly prescribed antimicrobials were azithromycin (30.15%), tinidazoles (25.25%) and ofloxacin (8.16%). Only 15.5% of drugs were prescribed with generic names and all were from essential list of medicines. 92.8% of prescriptions were administered orally, while 7.8% parenteral. However 76.34% of prescriptions were considered irrational.
 Conclusion: The high prevalence of irrational prescriptions suggests need for interventions to improve healthcare provider's adherence to established treatment guidelines. Dominance of specific drug classes underscores importance of tailoring treatments to the specific pathogens involved in Pelvic Inflammatory Disease. Suggesting potential room for improvement inadherence to evidence-based guidelines.

Assessment of private health sector prescribing patterns and adherence to prescription format using World Health Organization core drug use indicators in Addis Ababa, Ethiopia

BackgroundCurrently, the private healthcare sector's role in healthcare delivery is growing in Ethiopia. However, there are limited studies on private healthcare sector drug use patterns. This study aimed to evaluate the private healthcare sector prescribing practices and adherence to prescription format, using some of the World Health Organization (WHO) core drug use indicators in Addis Ababa, Ethiopia.MethodsA retrospective cross-sectional study design was used to collect quantitative data from prescriptions prescribed and dispensed by private healthcare sectors in the Lemi-Kura sub-city, Addis Ababa. The study was conducted from June to July 2021. The WHO criteria were used to evaluate prescribing and prescription completeness indicators. Prescriptions, kept for the last 1 year that were prescribed between January 1, 2020, to January 1, 2021, by private drug outlets, were analyzed. Simple random and systematic sampling procedures were employed in selecting drug outlets and prescriptions, respectively.ResultsOf a total of 1,200 prescriptions, 2,192 drugs were prescribed and the average number of drugs per prescription was 1.83. Generic names, antibiotics, injections, and drugs on the Ethiopian essential medicines list accounted for 77.4, 63.8, 11.5, and 80.6% of all prescriptions, respectively. Among the patient identifiers, the patient card number (54.3%), weight (2.3%), and diagnoses (31.7%) were less likely to be completed. In terms of the drug-related information, the dosage form (35.5%) was the least likely to be completed. Only 36.6 and 25.8% of prescriptions contained the names and qualifications of the prescribers, respectively. It was difficult to obtain prescription papers with the dispenser identifier.ConclusionThe study findings indicated prescribing and prescription completeness indicators all considerably deviated from WHO standards and hence unsuitable. This situation could be critical since a similar pattern is reported from public healthcare sectors, which might imply the extent of non-adherence to WHO core drug use standards. Consequently, it could play a considerable role in increasing irrational medicine use in Ethiopia.

Evaluation of prescription completeness, rational drug-use patterns using WHO prescribing, patient-care and facility indicators in Debre Tabor Comprehensive Specialized Hospital, Ethiopia: A cross-sectional study.

Objective:Irrational medicine use results in diseases worsening, disability, death, and wastage of limited resources. This study was predominantly aimed to evaluate the rationality of medicine use patterns by assessing prescribing, patient-care, and facility indicators at Debre Tabor Comprehensive Specialized Hospital by using World Health Organization core drug use indicators.Methods:A cross-sectional design was conducted to collect prescribing indicator data from 780 prescriptions retrospectively from 1 July 2020 to 30 June 2021 at outpatient pharmacy of the hospital and exit interview was held prospectively on 150 patients to evaluate patient-care indicators. In addition, indicators for health-facility were assessed by actual observation of the presence of different guidelines. Descriptive analysis of the collected data was computed using SPSS version 25.Result:Totally, 1521 drugs were prescribed to 780 encounters. On average, 1.95 drugs were prescribed per prescription. Percentage of encounters by generic name, encounters with antibiotics and injection, and drugs from essential drug list were 99.9%, 35.4%, 15.3%, and 100%, respectively. From healthcare provider–related information, the names of prescribers and dispensers were correctly written in 93.59% and 77.69%, respectively. Frequency (97.18%) and route (86.15%) of drug administration were better stated in the reviewed encounters, whereas dosage form is poorly stated (7.44%). Labeling of dispensed medicine was obtained for only 10% of patients and patient knowledge for correct dose was 94%. Availability of facility indicators was 95%.Conclusion:From the results of this study, it is possible to conclude that the prescribing, patient-care, and facility indicators did not fulfill many World Health Organization standards. Therefore, it is important if all prescribers, dispensers, patients themselves, and the governing bodies take an action to improve the prescribing and patient-care indicators for the best of the end users.

Rational Drug Use Evaluation Based on World Health Organization Core Drug Use Indicators in Ethiopia: A Systematic Review.

BackgroundRational use of medicines plays a vital role in avoiding preventable adverse drug effects, maximizing therapeutic outcomes with promoting patient adherence, and minimizing the cost of drug therapy. Irrational use of drugs is often observed in countries with weak health care systems. No review has been done that systematically expresses rational drug use practice based on the three WHO core drug use indicators in Ethiopia. Thus, this study was aimed to review systematically the prescribing, health-facility, and patient-care indicators based on WHO core drug use indicators in Ethiopia.MethodsA systematic article search was conducted in different electronic databases including PubMed/ MEDLINE, the Cochrane Library, EMBASE, Web of Science, POPLINE, the Global Health, and Google scholar. Quality assessment was conducted using Newcastle-Ottawa quality assessment scale. Studies were synthesized and grouped in to prescribing, patient care and health facility indicators.ResultsFrom a total of 6239 articles, 21 studies were found suitable for the review. The highest average number of drugs per encounter was 2.5 while the lowest was 0.98. The percentage of generic drug use was ranged from 70.5% to 100%. The highest percentage of encounters with an antibiotic was 85%. The lowest percentage of drugs prescribed from essential drugs list was 81.4%. The highest percentage of drugs actually dispensed and adequately labeled was 96.16% and 96.25%, respectively.ConclusionThis study showed that the practice of rational drug use varied across region of the country. The average number of drugs per prescription, percentage of drugs encounter with antibiotics, drugs prescribed by their generic name, average consultation time, average dispensing time, percentage of drugs adequately labeled, and availability of essential drugs showed deviation from the standard recommended by WHO. Thus, provision of regular training for prescribers and pharmacists, and ensuring the availability of essential drugs should be encouraged.

Evaluation of Medicine-Use Pattern Using World Health Organization's Core Drug-Use Indicators and Completeness of Prescription at University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia: Cross-Sectional Study.

BackgroundRational use of medicines is patients receiving medicines appropriate to their diagnosis in doses that meet their requirements for an adequate period of time at an affordable price. Irrational prescribing practices result in ineffective, unsafe treatment, prolong prognosis, and increase health-care costs, and this is a common phenomenon in Ethiopia. The aim of this study was to evaluate medicine-use pattern using World Health Organization core drug-use indicators and completeness of prescription at the University of Gondar Comprehensive Specialized Hospital.MethodsA retrospective and prospective cross-sectional descriptive study was conducted at the dispensing pharmacy units of the health facility from March 2019 to May 2019 using a systematic random sampling technique. Data were analyzed using SPSS version 24.0, and results are presented using tables.ResultsA total of 1,128 medicines were covered in the analyzed sample. The response rate, using standard prescription paper was found to be 100%. Mean number of medicines per prescription was 1.88. The proportion of medicines actually dispensed was 74.56%, and 91.4% medicines were prescribed by their generic names. Among prescribed medicines, antibiotics accounted for 37.5%, and 20% of the prescribed medicines were injectable. Prescriptions containing patient name, identification number, age, and sex comprised 99.8%, 99.5%, 91.8%, and 94.5%, respectively of the total. Prescriptions signed by prescribers accounted for 96.2%, however, only 75.8% of prescribers wrote their name. Moreover, only 4.8% of dispensers printed their name, and 32.7% of prescriptions were signed by pharmacists. Patient-care indicators were found to be below standard.ConclusionMost prescriptions were incomplete, and prescribers by far completed their role than dispensers. The health facility has standard prescription paper and updated pharmaceuticals list. Percentages for encounters with antibiotics, prescribing by generic name, and patient-care indicators deviated from the standard. The dispensing and counseling time also far from the standard, and most medicines were not labeled.

A drug utilization study of psychotropic drugs in indoor patients of psychiatry department in a tertiary care hospital

Context: The rapidly expanding field of psychopharmacology is challenging the traditional concepts of treatment and constantly seeking new drugs to treat psychiatric disorders. There is a sparse work on the utilization of psychotropic drugs in indoor patients. Hence, the present study was planned to add to the existing knowledge of the utilization of psychotropic drugs. Aims: The aims of were to study the drug utilization of psychotropic drugs in the indoor patients of psychiatry department and to evaluate it according to the World Health Organization core drug use prescribing indicators. Settings and Design: This was an observational study in indoor patients of psychiatry department in a medical college. Materials and Methods: In this study, patients of all age groups diagnosed with psychiatric disorder admitted to the psychiatry department were included. The data were collected from 300 prescriptions over 6 months. Data were analyzed using descriptive statistics. Results: In 300 prescriptions, 61.98% were psychotropic drugs and average number of drugs per prescription was five. The percentage of drugs prescribed by generic name and from the essential drug list was 52.93% and 60.9%, respectively. The most common diagnosis was schizophrenia (55.6%), followed by mood disorders (26.6%). The most commonly prescribed drugs for schizophrenia, bipolar disorders, and depression were olanzapine (71.85%), sodium valproate (71.4%), and escitalopram (51.6%), respectively. Conclusion: Most of the drugs were used in accordance with standard guidelines given by the Indian Psychiatric Society. The percentage of drugs prescribed by generic names and from the National List of Essential Medicines (NLEM) needs to be increased. Olanzapine, which is not included in NLEM, was commonly prescribed psychotropic drug

A world health organization core drug use indicator based prescription study in the dermatology outpatient department of a tertiary care teaching hospital of central South India

Background: Irrational prescribing is a universal problem that may lead to inadequate response to medication therapy, poor patient compliance and increased adverse drug reactions ultimately leading to frequent hospital admissions. Hence this study was done to assess the drug utilization pattern using WHO core drug use indicators so that the recommendation can be made towards the rational prescribing.Methods: A sample of 3650 prescriptions was analysed prospectively to assess the drug utilization patterns in the dermatology OPD of a tertiary care teaching hospital of central south India.Results: The average number of drugs per prescription was 2.74 whereas 79.26% drugs were prescribed by generic names. Percentage of encounters with an antibiotic prescribed was 18.68%. Regarding use of injections, 3.26% prescriptions contains one or more injections. Percentage of drugs prescribed from essential drugs list was 78.37%. Average consultation time was lower (2.9 minutes) than recommended.Conclusions: The data from the present study indicates that prevalence of polypharmacy, inadequate consultation and dispensing time along with poor patient’s knowledge are the areas of medication therapy to be improved. Availability of essential drugs and key drugs in stock should be improved to achieve rational therapeutic goal. Further, continued medical education regarding the rational prescribing will definitely improve the standards of health care delivery.

The prescribing pattern for the management of dengue fever in pediatric patients of a tertiary care hospital: an observational study

Background: Dengue fever is a mosquito borne viral infection which has become a global health hazard, especially in tropical and subtropical areas. Children have higher risk of developing severe forms of dengue fever, however, studies show that paediatric complications/fatalities from dengue fever are potentially avoidable by proper management. Data about drug usage patterns for dengue are particularly lacking, especially in the paediatric age group, therefore this study will help facilitate the rational use of drugs and aid in establishing a more specific management for dengue fever. The objective of the present study was to identify the prescribing pattern of dengue fever in paediatric inpatients admitted to RajaRajeswari Medical College and Hospital and assess according to the WHO core prescribing indicatorsMethods: This prospective observational study took place from March 2017 to September 2017 in the paediatric general wards. Data was collected from case files of NS1 positive patients of both genders between 1-18years. Data was analysed using descriptive statistics and expressed as percentages, means and standard deviations. The prescription pattern was analysed using the prescribing indicators mentioned in the World Health Organization core drug use indicators.Results: Total of 300 drugs were prescribed for 110 prescriptions that were analysed excluding IV fluids and blood products. Mean number of drugs prescribed was 2.7±0.8. Drugs prescribed by a generic name was 7.33%. Patients prescribed an antibiotic was 12.73%. Patients prescribed with an injection was 62.72% Majority of drugs prescribed in this study come from essential medicines list created by regulatory bodies. Intravenous fluids were administered to all patients with majority receiving normal saline (60.9%).Conclusions: Mainstay of treatment of dengue fever for paediatric patients is symptomatic along with focus on fluid management. Majority of drugs prescribed are from essential medicines lists formed by regulatory bodies. With dengue infections being a worldwide health hazard, more studies are needed to facilitate rational use of drugs in this disease.

Assessment of Drug Use Pattern Using WHO Prescribing Indicators

Background: In order to promote rational drug use in developing countries, assessment of drug use pattern using the World Health Organization drug use indicators is important. The aim of this study was to assess the drug prescription patterns at Kathmandu Medical College Teaching Hospital, using some of the World Health Organization core drug use indicators.Methods: A prospective cross-sectional study was carried out in order to determine current prescribing trends at Kathmandu Medical College Teaching Hospital. A total of 605 prescriptions were collected and analyzed in the study.Results: The average number of drugs per prescription was 5.85 considering the total amount of prescriptions. Furthermore, assuming each prescription as an individual patient, 64.1% of patients received antibiotics, and 71% of patients received injectable form of drugs. Among antibiotics the most common antibiotics prescribed were Ceftriaxone, Amoxicillin/Cloxacillin, Azithromycin, Cefixime, and Cloxacillin. Only 16.94% of the medicines were prescribed in generic names with the rest 83.06% of the medicines being prescribed in brand names and 47.55% of medicines prescribed were from the National List of Essential Medicines-Nepal.Conclusions: The current study revealed that polypharmacy and prescription writing using brand names were common. Prescriptions writing in generic nameneeds to be promoted and encouraged. There appears to be a crucial need for the development of prescribing guidelines when it comes to antibiotics.

The Assessment of Drug Use Pattern Using WHO Prescribing Indicators

Background: In order to promote rational drug use in developing countries, assessment of drug use pattern using the World Health Organization drug use indicators is important. The aim of this study was to assess the drug prescription patterns at Kathmandu Medical College Teaching Hospital, using some of the World Health Organization core drug use indicators.Methods: A prospective cross-sectional study was carried out in order to determine current prescribing trends at Kathmandu Medical College Teaching Hospital. A total of 605 prescriptions were collected and analyzed in the study.Results: The average number of drugs per prescription was 5.85 considering the total amount of prescriptions. Furthermore, assuming each prescription as an individual patient, 64.1% of patients received antibiotics, and 71% of patients received injectable form of drugs. Among antibiotics the most common antibiotics prescribed were Ceftriaxone, Amoxicillin/Cloxacillin, Azithromycin, Cefixime, and Cloxacillin. Only 16.94% of the medicines were prescribed in generic names with the rest 83.06% of the medicines being prescribed in brand names and 47.55% of medicines prescribed were from the National List of Essential Medicines-Nepal.Conclusions: The current study revealed that polypharmacy and prescription writing using brand names were common. Prescriptions writing in generic name needs to be promoted and encouraged. There appears to be a crucial need for the development of prescribing guidelines when it comes to antibiotics. Keywords: Drug prescription; drug utilization; prescribing practices; rational drug use; WHO prescribing indicators.

Evaluation of rational drug use based on World Health Organization core drug use indicators in selected public hospitals of eastern Ethiopia: a cross sectional study

BackgroundDespite the complexity of drug use, a number of indicators have been developed, standardized and evaluated by the World Health Organization (WHO). These indicators are grouped in to three categories namely: prescribing indicators, patient care indicators and facility indicators. The study was aimed to evaluate rational drug use based on WHO-core drug use indicators in Dilchora referral hospital, Dire Dawa; Hiwot Fana specialized university hospital, Harar and Karamara general hospital, Jigjiga, eastern Ethiopia.MethodsHospital based quantitative cross sectional study design was employed to evaluate rational drug use based on WHO core drug use indicators in selected hospitals. Systematic random sampling for prescribing indicators and convenient sampling for patient care indicators was employed. Taking WHO recommendations in to account, a total of 1,500 prescription papers (500 from each hospitals) were investigated. In each hospital, 200 outpatient attendants and 30 key essential drugs were also selected using the WHO recommendation. Data were collected using retrospective and prospective structured observational check list. Data were entered to EPI Data Version 3.1, exported and analyzed using SPSS version 16.0. Besides, the data were evaluated as per the WHO guidelines. Statistical significance was determined by one way analysis of variance (ANOVA) for some variables. P-value of less than 0.05 was considered statistically significant. Finally, tabular presentation was used to present the data.ResultsMean, 2.34 (±1.08) drugs were prescribed in the selected hospitals. Prescriptions containing antibiotics and that of injectables were 57.87 and 10.9% respectively. The average consultation and dispensing time were 276.5 s and 61.12 s respectively. Besides, 75.77% of the prescribed drugs were actually dispensed. Only 3.3% of prescriptions were adequately labeled and 75.7% patients know about the dosage of the prescription. Not more than, 20(66.7%) key drugs were available in stock while only 19(63.3%) of key drugs had adequate labeling. On average, selected key drugs were out of stock for 30 days per year. All of the hospitals included in the study used the national drug list, formulary and standard treatment guidelines but none of them had their own drug list or guideline.ConclusionMajority of WHO stated core drug use indicators were not met by the three hospitals included in the study.

Assessment of current prescribing practices using World Health Organization core drug use and complementary indicators in selected rural community pharmacies in Southern India

BackgroundDue to the lack of clear, comprehensive, and rational drug policy, the production of pharmaceutical preparations in India is distorted for the most part. Indian markets are flooded with more than 70,000 formulations, compared to approximately 350 formulations listed in the World Health Organization (WHO) Essential Drug List. Studies have indicated that majority of prescriptions in India are of drugs of “doubtful efficacy.” To promote rational drug use in developing countries, assessment of drug use patterns with the WHO drug use indicators is becoming increasingly necessary. The aim of this study was to assess the patterns of drug use by using WHO core drug use and complementary indicators.MethodsOne thousand fifty-two patients were prospectively interviewed and their prescriptions analyzed according to WHO guideline five randomly selected busy community pharmacies in northern district of the State of Tamil Nadu, South India to analyze the WHO core drug use and complementary indicators using an investigator-administered data collection form. The main outcome measured is patterns of drug use measured using WHO core drug use and complementary indicators.ResultsThe data obtained showed that, out of total drugs prescribed (3936), only 2.5 % (100) drugs were prescribed by generic name. Mean number of drugs per encounter was 3.7. Use of antibiotics was 22 %, percentage of encounters with an injection was 7.2 %, and the percentage of drugs prescribed from formulary was 99.8 %.ConclusionsBrand name prescribing is dominated even in rural India. There is a need to improve the availability of essential guidelines and key drugs in the stock in rural areas of India. Prescriptions studied were conforming to most indicators of WHO except the number of drugs prescribed & generic name prescription practice, which deviated. In India the healthcare is dominated by private practitioners at the primary level. Prescription practices of the individual community-based clinician needs consistent monitoring with respect to generic name prescribing habits as well as the number of drugs prescribed. The WHO drug use indicator guidelines need to be promoted amidst the primary care clinicians and should not be just limited to hospitals having a formulary. The data collected by this study can be used by policymakers to monitor and improve the prescribing and consumption of pharmaceutical products in Southern India.

Assessment of drug use pattern using World Health Organization core drug use indicators at Secondary Care Referral Hospital of South India

Objectives: The aim of this study was to assess the drug use pattern using World Health Organization (WHO) prescribing, patient care and health facility indicators at Secondary Care Referral Hospital of South India. Methods: A cross-sectional study was conducted at Secondary Care Referral Hospital of South India. WHO core drug use indicators questionnaire was used for the assessment of drug use pattern which comprise of five prescribing care indicators, five patient care indicators and two health facility indicators. 603 patient encounters were reviewed prospectively for a 6 months period from November 2013 to April 2014. Data were collected from outpatients of the pharmacy and results were represented in descriptive statistics. Results and Discussion: The average number of drugs prescribed per prescription was 2.7. The percentage of prescriptions in which antibiotics and injections were comprised about 9.6% (n = 159) and 1.6% (n = 27), respectively. The percentage of drugs prescribed by generic and from essential drug list (EDL) was 42.9% (n = 709), and 95.6% (n = 1578), respectively. The average consulting and dispensing time was 3.7 min and 2.3 min, percentage of drugs actually dispensed and adequately labeled was 96.6% and 99.3%. Percentage of patients had knowledge of correct dosage was 89.3%. The copy of EDL was available and the percentage of key drugs available was 88%. Conclusion: On the basis of above findings, the study was concluded that the prescribing indicators were met WHO standard criteria. The patient care and health facility indicators are rational and the importance of these indicators was encouraged by the doctors and the pharmacists. It shows that available drugs are satisfying unlimited healthcare needs of the public. Further, such studies at different regions of India and their review may produce beneficial results for the betterment of the society.

Patterns of antibiotic prescriptions in the outpatient department and emergency room at a Tertiary Care Center in Saudi Arabia

Objective: The aim of this study was to evaluate the extent and patterns of antibiotic prescription in the outpatient and the emergency departments of a tertiary care center in Makkah, Kingdom of Saudi Arabia. Materials and Methods: A cross-sectional study was carried out by reviewing the pharmacy electronic database from March to May 2013. The World Health Organization core drug use indicators were used. A random sample of 200 OPD and ER antibiotic prescriptions was obtained for detailed patient file review. Results: A total of 3872 antimicrobial prescriptions were identified. This constituted 16.2% of all OPD and ER prescriptions; 10% of OPD prescriptions and 47% of ER prescriptions contained at least one antibiotic. More than 50% of antibiotic prescriptions were not associated with the type of infection on the database. Co-amoxiclav and fluoroquinolones were the most frequently prescribed antibiotics. Conclusion: The overall percentage of antibiotic prescriptions in the OPD and the ER at the tertiary care center in Makkah are acceptable, but the percentage in the ER far exceeded the overall rate. Guidelines are needed to rationalize the prescription of antibiotics in the OPD and the ER.

Patterns of drug use in the public sector primary health centers of Bhopal district

To study drug use in public sector out-patient centers in Bhopal district, Madhya Pradesh Province, India. This study was conducted as part of the provincial health Department's efforts to develop a state drug policy. It was intended to inform policy elements concerned with the promotion of rational drug use. Health facilities studied included the functioning 9 primary health centers (rural) and 17 civil dispensaries (urban) in the district. World Health Organization core drug use (prescribing, patient care and facility) indicators were used. A total of 1,051 patient prescriptions were analyzed for prescribing indicators. Patient care indicators for 1,034 (of these patients) were measured. To study facility indicators, a list of 20 essential drugs was developed by the research team (as the province did not have its own drug list at the time of the study). The availability of these drugs was studied. Main outcome measure Core drug use indicators. The overall average number of prescribed drugs per patient was 2.76 (higher in rural than in urban centers). Only 1.4% of the 1,051 prescriptions did not have any drugs (non pharmacological management only). Generic drugs included 48.4% of all drugs prescribed. The proportion of consultations with antibiotics and injections prescribed was 63.5% and 13.8%, respectively. The proportion of drugs prescribed from the list we developed was 66.8%. Three quarter of all prescribed drugs were dispensed at the facility. In total, 87.1% of patients knew the dosage schedule of the medication prescribed. Antibiotic use in our setting was high, while generic drug prescribing was lower in comparison to other recent studies in Asia. The study provides a baseline measure against which changes in practice can be monitored as elements of the state drug policy are put into place.

Patterns of prescription and drug dispensing.

To analyze the patterns of prescriptions and drug dispensing using World Health Organization core drug use indicators and some additional indices. Data were collected prospectively by scrutinizing the prescriptions written by pediatric resident doctors and by interviewing parents of 500 outpatient children. The average number of drugs per encounter was 2.9 and 73.4% drugs were prescribed by generic name. Majority of drugs prescribed were in the form of syrups (60.8%). Use of antibiotics (39.6% of encounters) was frequent, but injection use (0.2% of encounters) was very low. A high number of drugs prescribed (90.3%) conformed to a model list of essential drugs and were dispensed (76.9%) by the hospital pharmacy. Certain drugs (5.7%) prescribed as syrups were not dispensed, although they were available in tablet form. Most parents (80.8%) knew the correct dosages, but only 18.5% of drugs were adequately labeled. No copy of an essential drugs list was available. The availability of key drugs was 85%. Interventions to rectify over prescription of antibiotics and syrup formulations, inadequate labeling of drugs and lack of access to an essential drugs list are necessary to further improve rational drug use in our facility.