Published: 2018-06-22

Study of drug prescription pattern in diarrhoea patients admitted to paediatric ward in a government tertiary care hospital in Maharashtra, India

Vinod S. Deshmukh, Swapnil P. Chube


Background: World Health Organization (WHO) has defined diarrhoea as, ‘the passage of loose stools by an individual, at least thrice a day or more frequently than normal’. It is most commonly caused by intestinal infection, mainly viral. Every year there are about 2 billion cases of diarrhoea worldwide, a second leading cause of mortality in children below the age of 5 years. WHO estimated that antibiotic treatment was necessary in only one in twenty cases of childhood diarrhoea. Yet huge resources are currently spent on anti-diarrhoeal drugs annually, most rendered useless or harmful. This study was proposed to evaluate the utilization pattern of drugs prescribed for diarrhoea in children, in a government tertiary care hospital in Maharashtra.

Methods: This cross-sectional observational study was carried out in the paediatric ward of government tertiary care hospital, Maharashtra. All patients of age less than twelve years with diarrhoea admitted to paediatric ward within the study period of January 2015 - June 2016 were included in the study. Patients older than twelve years or admitted with other gastrointestinal diseases or co-mordbid conditions were excluded. Statistical analysis was done using descriptive statistics.

Results: Majority of the patients admitted were males and more than half the patient population were in the age group of less than or equal to 3 years. Polypharmacy was found to be present in the prescribing pattern, with average, more than 4 drugs prescribed for diarrhoea treatment, in each prescription. Majority drugs were prescribed using brand names and parenteral route. Use of antibiotics was also found to be inappropriate in majority of the cases.

Conclusions: The study highlighted the importance of drug utilisation studies and pointed out inappropriate drug prescribing trends for diarrhoea cases in a tertiary care hospital in Maharashtra.


Diarrhoea, Drug utilisation study, Defined Daily Dose, Paediatrics, Polypharmacy

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Vishwanath M, Reddy SN, Devadas S. Assessment of drug utilization in hospitalized children at a tertiary care teaching hospital. J Chem Pharm Res. 2014;6(2):592-8.

Shamshy K, Begum I, Perumal P. Drug utilization of antimicrobial drug in paediatrics population in a tertiary care hospital in erode, Tamilnadu, India. Int J Pharm Tech Res. 2011;3(3):1530-6.

World Health Organization. The treatment of diarrhoea: A manual for physicians and other senior health workers. 4th rev. Geneva: Department of Child and Adolescent Health and Development, World Health Organization; 2005.

WHO. Diarrhoeal disease [Internet]. World Health Organization. 2016 [cited 13 July 2016]. Available at:

Pebley, Anne R. The State of the World’s Children 1989. Popul Dev Rev. 1989;15(2):376.

Kumar AM, Thulasi RK, Ramasamy C. Cross sectional prospective study on drug utilization in an outpatient paediatric department of tertiary care teaching hospital. Glob J Pharmacol. 2013;7(2):99-102.

Panchal JR, Desai CK, Iyer GS, Patel PP, Dikshit RK. Prescribing pattern and appropriateness of drug treatment of diarrhoea in hospitalised children at a tertiary care hospital in India. Int J Med Public Health. 2013;3:335-41.

Suman RK, Mohanty NC, Mohanty IR, Deshmukh YA. The study of drug usage patterns in pediatric Patients at MGM hospital, Navi Mumbai. World J of Pharmace Resear. 2014;3(4):734-43.

Deshmukh VS, Khadke VV, Patil AW, Lohar PS. Study of prescribing pattern of antimicrobial agents in indoor patients of a tertiary care hospital. Int J Basic Clin Pharmacol. 2013;2:281-5.

ATC/DDD Index 2016 [Internet]. WHO Collaborating Centre for Drug Statistics Methodology Norwegian Institute of Public Health; 2016 [cited 2016 September 5]. Available at:

Sharma L, Gupta R, Kapadia R, Gupta K, Singhal S, Gupta JK, Mathur M, Sharma K. Auditing of prescriptions in relation to diarrhea in children below 5 years of age: a multicenter study. Int Jof Basic & Clin Pharmacol. 2017 Jan 16;4(6):1208-13.

Pandey A, Sengupta PG, Mondal S, Gupta D, Manna B, Ghosh S, et al. Gender differences in healthcare-seeking during common illnesses in a rural community of West Bengal, India. J Health Popul Nutr. 2002;20:306-11.

Reddy S. Prescribing pattern of drugs in paediatric wards at a tertiary care teaching hospital. IJPRR. 2015;5(4):374-8.

Alam MB, Ahmed FU, Rahman ME. Misuse of drugs in acute diarrhoea in under five children. Bangladesh Med Res Counc Bull. 1998;24:27-31.

Mummad J. Audit of paediatric prescriptions for the common paediatric problems. Pak J Med Sci. 2007;23:932-5.

Palikhe N. prescribing pattern of antibiotics in paediatric Hospital of Kathmandu valley. Journal of Nepal Health Research Council. 2004;2(2):31-6.

Quick JD, Hogerzeil HV, Velasquez G, Rago L. Twenty-five years of essential medicines. Bull World Health Organ. 2002;80(11):913-4.

Shankar PR, Upadhyay DK, Subish P, Dubey A, Mishra P. Prescription patterns among paediatric inpatients in a teaching hospital in Western Nepal. Singapore Med J. 2006;47:261-4.

Mezgebe HB, Tadesse B, Legesse B. Antibiotics prescribing pattern in paediatric unit of Ayder referral hospital, Tigray region, Northern Ethiopia. J of Sci and Innov Resea. 2015;4(2):57-60.

Bordoloi P. Drug utilization study in the management of acute diarrhoea in the Paediatrics department at a tertiary health care institution. British J of Med and Heal Resea. 2016;3(7):46-55.

Ashraf H, Handa S, Khan NA. Prescribing pattern of drugs in out-patient department of Child Care Centre in Moradabad city. IJPSRR. 2010;3(2):1-5.

Maniar M, Shah I, Rao S. Antibiotic prescription patterns in children for upper respiratory tract infections and diarrhoea. JK Science. 2013;15(2):77-81.

Howteerakul N, Higginbotham N, Dibley MJ. Antimicrobial use in children under five years with diarrhoea in a Central Region Province, Thailand. Southeast Asian J Trop Med Public Health. 2004;35:181-7.

Pathak D, Pathak A, Marrone G, Diwan V, Lundborg CS. Adherence to treatment guidelines for acute diarrhoea in children up to 12 years in Ujjain, India-a cross-sectional prescription analysis. BMC infectious diseases. 2011 Dec;11(1):32.

Singh J, Bora D, Sachdeva V, Sharma RS, Verghese T. Prescribing pattern by doctors for acute diarrhoea in children in Delhi, India. J Diarrhoeal Dis Res. 1995;13(4):229-31.

WHO. WHO Collaborating Centre for Drug Statistics Methodology: Guidelines for ATC classification and DDD assignment 2015. Oslo: WHO; 2015.

WHO International Working Group for Drug Statistics Methodology. Introduction to Drug Utilization Research [Internet]. Oslo, Norway: WHO Collaborating Centre for Drug Utilization Research and Clinical Pharmacology; 2003 [cited 2016 July 20]. Available at: