Study of drug utilization in intensive care management of neonates at tertiary care hospital

Neeta C. S., Shailender Singh


Background: Newborn infants form a highly vulnerable group. Compared to adults they are more prone to adverse drug events. Exposure to multiple drugs is also known to be a leading factor in their well-being. Many advances have been made in this area, yet there is a paucity of information to guide rational prescribing in newborns. This study was conducted to evaluate the drug prescribing trends in a Neonatal Intensive Care Unit (NICU) of a tertiary care hospital in Bidar.

Methods: A prospective study was undertaken, over a period of 3 months at the government teaching hospital, Bidar. Neonates of either sex admitted to NICU were included. Data collection was done by scrutinizing the inpatient case sheets and investigation reports.

Results: A total of 100 neonates were admitted and 11 deaths were noted. Most common cause for admission was septicaemia. The total number of drugs prescribed was 488. The average number of drugs per prescription was 4.9. Antimicrobials were the commonest agents prescribed and intravenous route was the commonest route of drug administration. Most of the drugs were prescribed by generic names.

Conclusions: In our study it was observed that polypharmacy is commonly observed practice in NICU patients. Most of the antibiotics were prescribed empirically. The dose and frequency of administration was mostly as per the standard guidelines.


Antimicrobial utilization, Drug utilization, Neonates, Neonatal intensive care unit

Full Text:



Sachdeva PD, Patel BG. Drug utilization studies-scope and future perspectives.Int J Pharm Biol Res. 2010;1:11-7.

Ginsberg G, Hattis D, Sonawane B, Russ A, Banati P, Kozlak M, et al. Evaluation of child/adult pharmacokinetic differences from a database derived from the therapeutic drug literature. Toxicol Sci. 2002 Apr;66(2):185-200.

Agarwal R, Aul KV, Derorai KA. Essential pediatrics. 8th edition. New Delhi: CBS publishers and distributors; 2013.

Nash C, Simons E, Bhagat P, Bartlett A. Antimicrobial stewardship in the NICU: Lessons we’ve learned. Neoriviews. April 2014;15:116-122.10.1542.

Chatterjee S. drug utilization study in a neonatology unit of a tertiary care hospital in eastern India. 2007;16:1141-5.

McIntosh N, Helms P, Smyth R, Logan S. Forfar and Arneil’s Textbook of pediatrics. 7th Edition. China. Elsevier: 2008.

Stoll BJ, Hansen NI, Sánchez PG, Faix RG, Poindexter BB, Van Meurs KP, et al. Early onset neonatal sepsis: the burden of group B Streptococcal and E. coli disease continues. Pediatrics. 2011;127(5):817-26.

Tripathi N, Cotton CM, Smith PB. Antibiotic use and misuse in the neonatal intensive care unit. Clin Perinatol. 2012;39(1):61-8.

Koda-kimble MA, Young LY. Alldredge BK, Corelli RL, Guglielme BJ, Kradjan WA. Applied therapeutics: The clinical use of drugs. 9th edition. United States of America. Lippincott Williams and wilkins/ Wolters Kluwer. 2008.

Tripathi NBS, Cotton MC, Smith PB. Antibiotic use and misuse in neonatal intensive care unit. Clinics in perinatology. March 2012; 39(1).

WHO International working group for drug statistics Methodology. Introduction to Drug Utilization Research (Internet). Oslo, Norway; WHO Collaborating center for Drug Utilization Research and Clinical Pharmacology; 2003. Available from:

Einarson T, Bergman U, Wiholm B. Principles and practice of Pharmacoepidemiolgy. Avery’s Drug Treatment. 4th ed. AdisIntemational; 1999:371-392.

Ozgenç O, Genç VE, Arı AA, El Sibel, Saçar S, Ozunlu H et al. Evaluation of the therapeutic use of antibiotics in Aegean Region hospitals of Turkey: A multicentric study. Indian Journal of Medical Microbiology. 2011;29(2):124-9.

Afsharpaiman. Neonatal sepsis and antibiotic susceptibility in two neonatal intensive care unit in Iran. Journal of clinical neonatology. 2012;1(3):124-30.

KRS SS. A study on prescription of antibiotic utilization in neonatal intensive care unit at a tertiary care center. Int J Med Res Health sci. 2015;4(2):265-8.

Sharanappa. Pattern of drug utilization in neonatal intensive care unit in a tertiary care hospital. IJBR. 2014;5(09):582-4.

Sheth KV, Patel TK, Tripathi CB. Antibiotic sensitivity pattern in Neonatal Intensive Care Unit of a tertiary care hospital India. Asian J Pharm Clin Res. 2012;5(3):46-50.

Tzilla C, Borghesi A, Serra G, Stronati M, Corsello G. antimicrobial therapy in neonatal intensive care unit. Italian journal of pediatrics. 2015;41:27.10.1186.

Warrier I, Wei D, Natarajan G, Vali S, Aranda J. Patterns of Drug Utilization in a Neonatal Intensive Care Unit. Journal of Clinical Pharmacology, 2006;46:449-55.