The prescribing pattern for the management of dengue fever in pediatric patients of a tertiary care hospital: an observational study

Shruthi Rammohan, Basavaraj Bhandare, Adarsh E., Satyanarayana V.


Background: Dengue fever is a mosquito borne viral infection which has become a global health hazard, especially in tropical and subtropical areas. Children have higher risk of developing severe forms of dengue fever, however, studies show that paediatric complications/fatalities from dengue fever are potentially avoidable by proper management. Data about drug usage patterns for dengue are particularly lacking, especially in the paediatric age group, therefore this study will help facilitate the rational use of drugs and aid in establishing a more specific management for dengue fever. The objective of the present study was to identify the prescribing pattern of dengue fever in paediatric inpatients admitted to RajaRajeswari Medical College and Hospital and assess according to the WHO core prescribing indicators

Methods: This prospective observational study took place from March 2017 to September 2017 in the paediatric general wards. Data was collected from case files of NS1 positive patients of both genders between 1-18years. Data was analysed using descriptive statistics and expressed as percentages, means and standard deviations. The prescription pattern was analysed using the prescribing indicators mentioned in the World Health Organization core drug use indicators.

Results: Total of 300 drugs were prescribed for 110 prescriptions that were analysed excluding IV fluids and blood products. Mean number of drugs prescribed was 2.7±0.8. Drugs prescribed by a generic name was 7.33%. Patients prescribed an antibiotic was 12.73%. Patients prescribed with an injection was 62.72% Majority of drugs prescribed in this study come from essential medicines list created by regulatory bodies. Intravenous fluids were administered to all patients with majority receiving normal saline (60.9%).

Conclusions: Mainstay of treatment of dengue fever for paediatric patients is symptomatic along with focus on fluid management. Majority of drugs prescribed are from essential medicines lists formed by regulatory bodies. With dengue infections being a worldwide health hazard, more studies are needed to facilitate rational use of drugs in this disease.


Dengue fever, Prescribing pattern, Paediatrics, Rational prescribing

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World Health Organization. Dengue and Severe Dengue Fact sheet. Available at:

Azeredo EL, Monteiro RQ, de-Oliveira Pinto LM. Thrombocytopenia in dengue: interrelationship between virus and the imbalance between coagulation and fibrinolysis and inflammatory mediators. Mediators Inflammation. 2015;2015.

Selvan T, Nagaraj MV, Saravanan P, Somashekar. A study of clinical profile of dengue fever in children. Int J Contemp Pediatr. 2017 Feb 22;4(2):534-7.

Mutheneni SR, Morse AP, Caminade C, Upadhyayula SM. Dengue burden in India: recent trends and importance of climatic parameters. Emerging Microbes Infections. 2017 Aug;6(8):e70.

Dutta S, Beg MA, Bawa S, Anjoom M, Vishal S. Study of drug prescribing pattern in dengue patients in a tertiary care hospital: a tool to teach clinical pharmacology. J Drug Delivery Therapeutics. 2015 March;5(2):73-6.

Bandyopadhyay B, Bhattacharyya I, Adhikary S, Konar J, Dawar N, Sarkar J, et al. A comprehensive study on the 2012 dengue fever outbreak in Kolkata, India. ISRN Virol. 2013 Aug 7;2013.

Pancharoen C, Thisyakorn U. Dengue virus infection during infancy. Trans R Soc Trop Med Hyg. 2001;95(3):307-8.

Ghazala Z, Anuradha HV, Shivamurthy MC. Pattern of management and outcome of dengue fever in pediatric in-patients in a tertiary care hospital: a prospective observational study. Int J Basic Clin Pharmacol. 2014;3(3):534-8.

Rani U, Kamath S, Varun HV, Aithal S, Patil U. Prescribing patterns in dengue fever in paediatric patients in a tertiary care hospital: a retrospective cross sectional study. Int J Pharm Sci Rev Res. 2014;24(2):112-18.

Vaddadi S, Vaddadi RS. Dengue fever: a review article. J of Evolution of Med and Dent Sci. 2015;4(29):5048-58.

Lee TH, Wong JG, Leo YS, Thein TL, Ng EL, Lee LK, et al. Potential harm of prophylactic platelet transfusion in adult dengue patients. PLoS Neglected Tropical Diseases. 2016 Mar 25;10(3):e0004576.

Aravamuthan A, Arputhavanan M, Subramaniam K. Assessment of current prescribing practices using World Health Organization core drug use and complementary indicators in selected rural community pharmacies in Southern India. J Pharmaceut Policy Practice. 2017 Dec;10(1):1.

WHO 20th Essential Medicines List, 2017, 1-62. Available at:

National List of Essential Medicines of India. 2015, 1-117. Available at:,%202015.pdf.

Soegijanto S. The Monthly changing of the lowest population dengue virus infection in patient at Soerya Hospital Sidoarjo In 00. Indonesian J Tropical Infectious Dis. 2015 May 27;2(1):20-4.

Hung NT. Fluid management for dengue in children. Paediatr Int Child Health. 2012 May 1;32(sup1):39-42.

World Health Organization. How to investigate drug use in Health Facilities: selected drug use indicators. Geneva.1993. Available at:

Basha SA, Sathiswara B, Siddarama R. Prescribing pattern of drugs in pediatric department in a tertiary care teaching hospital. World J Pharmacy Pharmaceutical Sci. 2018;7(2):1129-36.