Study of drug use in outdoor pediatric patients of upper respiratory tract infections in a tertiary care hospital

Usha Joshi, Rajesh Hishikar, Suraj Agrawal, Ajay Halwai, Lopamudra Kirtania, Kavita Kurrey


Background: Upper respiratory tract infections (URTI) are the most common and frequent occurring infections in the pediatric population. URTI is mostly viral in origin and requires mostly symptomatic treatment. The present study was undertaken to analyze the pattern of drug use in the management of URTI in the pediatric age group.

Methods: It is a retrospective study to assess the pattern of drug use in URTI in pediatric outpatient department during the 5 months period from January 2015 to May 2015.

Results: A total of 2256 prescriptions were analyzed. Most of the pediatric patients belonged to 1-5 years age group and 58.33% were males, and 41.66% were females. A total of 6332 drugs were prescribed out of which the antibiotics used was 1341. The average number of drugs per prescription used was 2.81. The percentage of prescriptions containing antibiotics was found to be 59.44%. Amoxicillin (70.91%) was the most frequent prescribed antibiotic followed by cotrimoxazole (10.21%). Antihistaminic and expectorant combinations were found to be the most common prescribed class of drugs (29.34%) followed by analgesic and antipyretics (26.45%) and antibiotics (21.17%).

Conclusions: The study revealed that the majority of children were below 5 years of age. The most common class of drugs prescribed was antihistaminics and expectorant combinations followed by analgesics and antipyretics. Although the majority of the patients received antibiotics, 40.55% of patients received symptomatic treatment. This is a welcome step as inappropriate use of the antibiotics can potentiate to the increasing trend of antimicrobial resistance.


Upper respiratory tract infections, Pediatric, Prescription, Antibiotics

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Behrman RE, Kliehman RM, Jenson HB. Infection of upper respiratory tract. Nelson Textbook of Paediatrics. Philadelphia: W.B. Saunders Company; 2000: 1261.

Feld LG, Hyams JS. Respiratory tract infections in children: new development in diagnosis and treatment. Consens Paediatr. 2009;1(11):1-46.

Cotton M, Innes S, Jaspan H, Madide A, Rabie H. Management of upper respiratory tract infections in children. S Afr Fam Pract. 2008;50:6-12.

Hueston WJ, Mainous AG 3rd, Ornstein S, Pan Q, Jenkins R. Antibiotics for upper respiratory tract infections. Follow-up utilization and antibiotic use. Arch Fam Med. 1999;8(5):426-30.

Schappert SM. Vital Health Statist. Volume 13. Maryland: National Centre for Health Statistics; 1994.

Mossad SB. Upper Respiratory Tract Infection. Cleveland Clinic. Department of Infectious Disease. Available at Accessed 19 June 2015.

Pharyngitis. Ear, nose and throat disorders. The Merck Manual of Diagnosis and Therapy. Section 7, Chapter 87. Available at Accessed 19 June 2015.

Clark M, Kumar P, Ballinger A, Patchett S. Saunder’s Pocket Essentials of Clinical Medicine. 3rd Edition. London: Elsevier; 2004.

Fahey T, Stocks N, Thomas T. Systematic review of the treatment of upper respiratory tract infection. Arch Dis Child. 1998;79(3):225-30.

Jain N, Lodha R, Kabra SK. Upper respiratory tract infections. Indian J Pediatr. 2001;68(12):1135-8.

NICE. Respiratory tract infections – Antibiotic prescribing. Prescribing of antibiotic for self-limiting respiratory tract infections in adults and children in primary care. London, UK: National Institute of Health and Clinical Excellence; 2008: 1-122.

Simasek M, Blandino DA. Treatment of the common cold. Am Fam Physician. 2007;75(4):515-20.

Rosentein N, Phillips WR, Gerber MA, Marcy MS, Schwartz B, Dowell SF. The common cold – Principles of judicious use of antimicrobial agents. Paediatric. 1998;101:181-4.

Grijalva CG, Nuorti JP, Griffin MR. Antibiotic prescription rates for acute respiratory tract infections in US ambulatory setting. JAMA. 2009;302(7):758-66.

Roumie CL, Halasa NB, Grijalva CG, Edwards KM, Zhu Y, Dittus RS, et al. Trends in antibiotic prescribing for adults in the United States – 1995 to 2002. J Gen Intern Med. 2005;20(8):697-702.

S KI, Chandy SJ, Jeyaseelan L, Kumar R, Suresh S. Antimicrobial prescription patterns for common acute infections in some rural & urban health facilities of India. Indian J Med Res. 2008;128(2):165-71.

Wang EE, Einarson TR, Kellner JD, Conly JM. Antibiotic prescribing for Canadian preschool children: evidence of overprescribing for viral respiratory infections. Clin Infect Dis. 1999;29(1):155-60.

Nyquist AC, Gonzales R, Steiner JF, Sande MA. Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis. JAMA. 1998;279(11):875-7.

Alumran A, Hurst C, Xiang-Yu H. Antibiotic overuse in children with upper respiratory tract infection in Saudi Arabia: risk factor and potential interventions. Clin Med Diagn. 2011;1(1):8-16.

Sawalha A, Al-Bishtawi G, Al-Khayyat L, Sweileh W, Al-Ramahi R, Jaradat N. Pattern of parenteral antimicrobial prescription among paediatric patients in Al-Watani Government Hospital in Palestine. An-Nazah Univ J Res. 2006;20:191-206.

Thandu SK, Kumar R, Patil VG, Dighe D, Lalan HN, Singh A. Drug utilization pattern in upper respiratory tract infections in ENT outpatient department of tertiary care hospital. Indian J Appl Res. 2014;4:484-7.

Das B, Sarkar C, Majumder AG. Medication use for pediatric upper respiratory tract infections. Fundam Clin Pharmacol. 2006;20(4):385-90.

Mungrue K, Brown T, Hayes I, Ramroop S, Thurston P, Pereira LP. Drugs in upper respiratory tract infections in paediatric patients in North Trinidad. Pharm Pract (Granada). 2009;7:29-33.

Kumar R, Indira K, Rizvi A, Rizvi T, Jeyaseelan L. Antibiotic prescribing practices in primary and secondary health care facilities in Uttar Pradesh, India. J Clin Pharm Ther. 2008;33(6):625-34.