DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20183026

Drug utilization study in a neonatal intensive care unit of a government tertiary care hospital in Western Maharashtra

Arvind V. Kumbhar, Nimish R. Halasawadekar, Sunita J. Ramanand, Jaiprakash B. Ramanand, Praveen T. Patil, Ruchi D. Shah, Arundhati T. Salunke

Abstract


Background: Presently drug utilization studies (DUS) are in an evolving era. Current literature search has shown paucity of epidemiological studies in the field of paediatric pharmacology. Hence the present study was designed to assess the drug utilization pattern in neonatal intensive care unit to improvise the current prescription practices, if required and to determine areas in neonatal pharmacology in need of further research.

Methods: A prospective, observational study spanned for a period of one year from January 2015 to December 2015 was conducted at the neonatal intensive care unit (NICU), Government teaching tertiary care hospital, Maharashtra. Data of prescribed drugs was collected. WHO prescribing indicators were used for evaluating DUS. Assessment of exposure rates of different class of drugs in different gestational age groups was done. Data were analysed using descriptive studies.

Results: Data of 205 neonates, showed male preponderance (53.17%) over female neonates (46.83%). With regard to the gestational age, 47.31% were term, 52.68% preterm. Average number of drugs per encounter was 6.69. 76.29% drugs were prescribed by generic name and 69.80 % drugs were from IAP list of essential medicines for children. Mean drug use was 6.23±3.34 per patient. Most common class of drug to which neonates were exposed was antibiotics (96.10%) and amikacin topped the list with exposure rate of 91.22%.

Conclusions: The present study substantiates the need for implementation of institutional antibiotic policies, awareness regarding IAP list of essential drugs for children, prescription by generic name and rational drug use.


Keywords


Drug utilization study, Exposure rate, Mean drug use, Neonates, NICU

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References


Stempel DA, Durcannin-Robbins JF, Hedblom EC, Woolf R, Sturm LL, Stempl AB. Drug utilization evaluation identifies costs associated with high use of beta-adrenergic agonists. Ann Allergy Asthma Immunol. 1996;76:153-58.

Introduction to Drug Utilization Research [Internet]. Geneva: World health Organization; 2003. (Cited 2016 Apr 12). Available at: http://apps.who.int/medicinedocs/pdf/s4876e/s4876e.pdf

Neubert A, Lukas K, Leis T, Dorman H, Brune K, Rascher W. Drug utilization on a preterm and neonatal intensive care unit in Germany: a prospective, cohort based analysis. Eur J Clin Pharmacol. 2010;66:87-95.

Preterm birth. World Health Organizations (WHO). [Internet] Fact sheet N°363 Updated; November 2015. [cited 10 October 2016]. Available at: http://www.who.int/mediacentre/factsheets/fs363/en/#

Low Birth weight: Country, regional and global estimates [Internet]. United Nations Children’s Fund and World Health Organization UNICEF, New York; 2004. [cited 2016 Mar 12]. Available at: http://www.unicef.org/publications/index_24840.html

WHO. How to investigate drug use in health facilities: selected drug use indicators [Internet]. (WHO/DAP/93.1). Geneva: Action Programme on Essential Drugs, World Health Organization; 1993:1-87. [cited 2016 May 5]. Available at: apps.who.int/medicinedocs/en/d/Js2289e/4.4.html

Indian Academy of Pediatrics List of Essential Medicines for Children of India [Internet]. New Delhi: Indian Academy of Pediatrics; 2011. [cited 2016 Nov 10]. Available at: http://www.who.int/medicines/publications/essentialmedicines/4th_EMLc_FINAL_web_8Jul13.pdf

Venkateswaramurthy N, Murali R, Kumar SR. The study of drug utilization pattern in pediatric patients. Int J Pharm Pharm Sci. 2013;5:140-4.

Warrier I, Du W, Natarajan G, Patterns of Drug utilization in a Neonatal Intensive Care Unit. J Cli Pharmacol. 2006:46:449-55.

Chatterjee S, Mandal A, Lyle N, Mukherjee S, Singh AK. Drug utilization study in a neonatology unit of a tertiary care hospital in eastern India. Pharmacoepidemiology and drug safety. 2007;16:1141-5.

Behrman RE, Kleigman RM, Jenson HB, (eds). The foetus and the neonatal infant. In Nelson Textbook of Pediatrics, 17th Edn. An Imprint of Elsevier: Philadelphia; 2004;519-640.

Dawodu T, Douma C, Patnode R. Appendix A: common NICU medication guidelines. In Manual of Neonatal Care, 5th Edn. Cloherty JP, Eichenwald EC, Stark AR (eds). Lippincott Williams and Wilkins: Philadelphia; 2004:717-747.

Fonseca SS, Ehrenkranz RA, Baltimore RS. Epidemiology of Antibiotic Use in a Neonatal Intensive Care Unit. Infection Control and Hospital Epidemiology. 1994;15:156-62.

Bonati M, Brambilla C, Colombo F, Tognoni G, Bergher C, Bottino S, et al. Early neonatal drug utilization in preterm newborns in neonatal intensive care units, Italian collaborative group on preterm delivery. Developmental Pharmacology and Therapeutics. 1988;11:1-7.

Jain A, Agarwal R, Jeeva Sankar M, Deorari A, Paul VK. Hypocalcemia in The Newborn. Indian J Pediatr. 2010;77:1123-8.