Drug utilization study in neonatal intensive care unit of a tertiary care teaching hospital


  • Jayeshkumar P. Vaghela Clinical Pharmacologist, Ontario, Canada
  • Anupama Sukhlecha Department of Pharmacology, M P Shah Govt. Medical College, Jamnagar, Gujarat, India




Antibiotics, Drug utilization, Essential medicine list, Neonates, Rationality


Background: Sick and pre-term neonates are admitted in neonatal intensive care units (NICU) and treated. A great care needs to be taken to use drugs in neonates due to the immaturity of their body functions. There is a lack of standard drug prescribing guideline in children, especially neonates because; safety and efficacy for a majority of drugs have not been established in them. The objectives of the study were to evaluate the drug utilization pattern in NICU of a teaching hospital and to identify problems in drug utilization and suggest measures, if needed.

Methods: A prospective, observational study was carried out in NICU for duration of one year. Demographic details like age, sex, birth weight, duration of hospitalization was recorded from the case files of neonates. The morbid condition, treatment with drugs and other supportive modalities were recorded. The outcome of treatment was also noted. WHO drug utilization core indicators were also evaluated.

Results: Out of 623 admissions in NICU, 56% were males. There were 56% of neonates who were born pre-term. The maximum used drugs were Vitamin K (73%) and antibiotics (64%). The antibiotics were mainly from penicillin and aminoglycoside groups. Respiratory distress syndrome (19%) and neonatal sepsis (16%) were the most common causes for admission. Out of total admissions, 64% were discharged following recovery, while, 12% had expired.

Conclusions: Drugs usage in neonates should be minimal and should be prescribed from essential drug list. Antibiotic policy needs to be formulated for hospitals to minimize antibiotic usage and prevent development of resistance.


The use of essential drugs. Ninth report of the WHO Expert Committee. Geneva, World Health Organization, 2000 (WHO Technical Report Series, No. 895).

Introduction to Drug Utilization Research. Oslo: World Health Organization. Chapter 1. What is drug utilization research and why is it needed; 2003:8-12.

Warrier I, Wei D, Girija N, Salari V, Aranda J. Patterns of Drug Utilization study in Neonatal Intensive care unit. J Clin Pharmacol. 2006;46:449-55.

Shankar PR, Partha P, Dubey AK, Mishra P, Deshpande VY. Intensive care unit drug utilization in a teaching hospital in Nepal. Kathmandu Uni Med J. 2005;3(10):130-7.

World Health Organization. How to investigate drug use in health facilities: Selected drug use indicators. World Health Organization. Chapter 2, Core drug use indicators; 1993:12-24.

Desai S. Editor. Indian Drug Review-triple I. CMP Medica India Pvt Limited, Bangalore, India; 2015:1.

National List of Essential Medicines of India. 2011;1-123. Available at: https://www.nhp.gov.in/national-list-of-essential-medicines-2011_pg [Last accessed on 2017 August 12]

Medicines WHO. WHO model list of essential medicines for children 2013; 1-35. Available at: http://www.who.int/medicines/publications/essentialmedicines/18th_EML.pdf [Last accessed on 2017 August 12]

Parkash J, Das N. Pattern of admissions to neonatal unit. J Coll Physicians Surg Park. 2005;15(6):341-4.

Narayan R. A study of the pattern of admissions and outcome in a neonatal intensive care unit at high altitude. Sri J Child Health. 2012;41(2):79-81.

Dhanraj G, Francis R, Srinivas R. Morbidity and mortality patterns of neonatal emergency in Gujarat - Case study of GVK EMRI. Available at: http://www.emri.in/images/stories/Morbidity%20and%20mortality%20patterns.pdf. [Last accessed on 2017 August 12]

Rakhia A, Khan M, Memon AA, Dahar SA. Pattern and outcome of neonatal ailments in a tertiary care hospital. Pak J Med Res. 2014;14(1):14-6.

Kliegman RM, Behrman RE, Jenson HB, Stanton BF. Nelson Textbook of Pediatrics, 18th Ed. New Delhi: Elsevier Publication. Chapter 97. The High Risk Infant; 2008:701-708.

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

Uppal R, Chhabra A, Narang A. Pattern of Drug Use in neonatal intensive care unit. Indian Pediatr. 1998;35:647-9.

Clark RH, Bloom BT, Spitzer AR, Dale RG. Reported medication use in the neonatal intensive care unit: Data from a large national data set. J Pediatr. 2006;117(6):1979-87.

Lesko SM, Epstein MF, Mitchell AA. Recent patterns of drug use in newborn intensive care. J Pediatr. 1990;116:985-90.

Jain NK, Jain VM, Maheshwari S. Clinical profile of neonatal sepsis. Kathmandu Univ Med J. 2003;1(2):117-20.

Monsef A, Eaghbalian F. Antibiotic sensitivity pattern of common bacterial pathogens in NICU and neonatal ward in Hamedan province of Iran. Health. 2010;2(6):625-29.

Zaidi AK, Huskins WC, Thaver D, Bhutta ZA, Abbas Z, Goldmann DA. Hospital acquired neonatal infections in developing countries. Lancet. 2005;365:1175-88.

Stocker M, Ferrao E, Banya W, Cheong J, Macrae D, Furck A. Antibiotic surveillance on a pediatric intensive care unit: easy attainable strategy at low costs and resources. BMC Pediatr. 2012;12:196.

Child Health Division, Ministry of Health and Family Welfare, Government of India. Operational Guidelines: Injection Vitamin K Prophylaxis at Birth (in facilities). Available at: http://tripuranrhm.gov.in/Guidlines/3006201401.pdf [Last accessed on 2017 August 12]

Schmidt-Sommerfeld E, Penn D. Carnitine and total parenteral nutrition of the neonate. Biol Neonate. 1990;58(1):81-8.

Bhutani VK. Phototherapy to prevent severe neonatal hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Paediatr. 2011;128(4).

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. Pharmacoepidemiol Drug Safety. 2007;10:1141.

Rahim F, Jan A, Mohummad J, Iqbal H. Pattern and outcome of admissions to neonatal unit of Khyber teaching hospital, Peshawar. Pak J Med Sci. 2007;23(2):249-53.

Chishty AL, Iqbal A, Anjum A, Maqbool S. Spectrum of multiorgan systemic involvement in birth asphyxia. Pak J Pathol. 2001;12:81-7.




How to Cite

Vaghela, J. P., & Sukhlecha, A. (2017). Drug utilization study in neonatal intensive care unit of a tertiary care teaching hospital. International Journal of Basic & Clinical Pharmacology, 6(10), 2510–2515. https://doi.org/10.18203/2319-2003.ijbcp20174386



Original Research Articles