Published: 2020-08-25

Drugs used in wheeze associated respiratory infection among children in tertiary care teaching hospital

Kamalavarshini Paramasivamsasanger, Bhakiyanathan Arumugam, Parimalakrishnan Sundararajan, Praveen Kumar Ravi Kumar


Background: This study was done to study the drugs used in wheeze associated lower respiratory infected paediatric patients in tertiary care teaching hospital.

Methods: Sample size was calculated as 78 and patients were selected based on the inclusion and exclusion criteria. The study was a prospective observational study and conducted in Department of Pediatrics, Rajah Muthiah Medical College and Hospital (RMMCH), Annamalai University.

Results: Our study shows that male children (63%) are affected with more than female children (37%). The most frequently prescribed drugs are antibiotics (96%), antipyretics (63%), expectorants and antitussives (54%) followed by beta adrenergic agonist (46%), beta adrenergic agonist with anticholinergic combination (14%) corticosteroids (18%). Our study also shows wheeze associated lower respiratory infection (WALRI) in children were significantly associated with bacterial infections (72%).

Conclusions: Our study concluded that antibiotics and antipyretics are the most commonly prescribed drugs for WALRI followed by expectorants and antitussives, beta adrenergic agonist, corticosteroids, beta adrenergic agonist with anticholinergic combination. Most of the treatment strategies are adopted from Standard Treatment Guidelines (STG) and World Health Organisation (WHO). The average number of prescribed drugs per encounter was more than that of WHO standards. The percentage of encounters in which an antibiotics and injections was higher than the ideal WHO standards it leads to anti-microbial resistance and costly forms of drug therapy.


Antibiotics, Antipyretics, Cost analysis, Prescription pattern, STG, WALRI, WHO

Full Text:



Henderson FW, Clyde Jr WA, Collier AM, Denny FW, Senior RJ, Sheaffer CI, et al. The etiologic and epidemiologic spectrum of bronchiolitis in pediatric practice. J Pediatr. 1979;95(2):35-9.

Saha E, Patra D, Kumar A, Banerjee P. Efficacy of bronchodilators in wheeze associated respiratory tract infections. Indian Med Gazette. 2014;148(1):13-9.

From the Global Strategy for Asthma Management and Prevention. Global Initiative for Asthma (GINA) 2015. Available at:

Vindhiya AK, Bhagavathy S. Clinical features and prevalence of asthma and wheeze associated lower respiratory infection in children. Res J Med Allied Sci. 2017;14.

Management of common Respiratory Infections in Children in India, Ministry of Health and Family Welfare Government of India. 2016. Available at:

Hussain S, Yadav SS, Sawlani KK, Khattri S. Assessment of drug prescribing pattern using world health organization indicators in a tertiary care teaching hospital. Indian J Public Health. 2018;62(2):156.

World Health Organization, Rational use of Medicines. 2010. Available at: Accessed on 18 August 2016.

Hauben EI, Hogendoorn PCW. Bone Cancer Progression and therapeutic Approaches. 1st ed. UK, Elsevier; 2010:3-8.

Binu KM, John NN, Mathew AL, Doddayya H, Malpani AK. Drug use evaluation of bronchodilators in pediatrics in a tertiary care hospital. IJPSR. 2012;3(10): 3983-7.

Bhuket TR, Sunakorn P, Suwanjutha S, Nawanoparatkul S, Teeyapaiboonsilpa P. Wheezing-associated lower respiratory infections in under 5-year-old children: study in Takhli District Hospital. J Medical Assoc Thailand. 2002;85:S1247-51.

Badar V, Parulekar V, Garate P. A prescription pattern study of respiratory tract infections in paediatric indoor patients in a tertiary care teaching hospital–A prospective observational study. Asian J Pharm Clin Res. 2018;11(7):251.

Antibiotic resistance, fact sheet. World Health Organization. Available at: news-room/fact-sheets/detail/antibiotic-resistance.

Antimicrobial resistance, fact sheet. World Health Organization. Available at: health-topics/antimicrobial-resistance.

Teja NK, Hazra P, Padma L. Audit of Prescriptions from the department of general medicine based on the WHO core prescribing indicators at sapthagiri hospital, Bangalore. Int J Basic clin Pharmacol. 2019;8(12):2759-62.

Jainam SV, Kalyani PN, Shrikalp DS. Pharmacoeconomic evaluation, cost minimization analysis of anti-diabetic therapy in Gujarat. Int J Med Res Health Sci. 2016;5(3):34-43.