A Study of the Antimicrobial Drug Usage Pattern among In-Patients and Out-Patients at the Paediatrics Department at Tertiary Care Teaching Hospital

Sireesha Arikati; Afrozpatan Afrozpatan; Prapurna Chandra Yadala

doi:10.70604/

Authors

Arikati Sireesha II Year M.Pharmacy Department of Pharmacy practice,, Ratnam Institute of Pharmacy , Pidathapolur (V&P), Muthukur (M) , SPSR Nellore District -524 346.
Afrozpatan Department of Pharmacy Practice, Ratnam Institute of Pharmacy , Pidathapolur (V&P), Muthukur (M) , SPSR Nellore District -524 346.
Yadala Prapurna Chandra Department of pharmacology ,Ratnam Institute of Pharmacy , Pidathapolur (V&P), Muthukur (M) , SPSR Nellore District -524 346

Abstract

Background: Antimicrobials are among the most frequently prescribed drugs in paediatric practice; however, their irrational and excessive use contributes to adverse drug reactions (ADRs), antimicrobial resistance, and increased healthcare costs. Drug utilisation studies (DUS) help evaluate prescribing patterns and support antimicrobial stewardship programmes. This study aimed to assess antimicrobial prescribing patterns and monitor ADRs among paediatric inpatients and outpatients using WHO core prescribing indicators.

Methods: A 12-month cross-sectional observational study was conducted in the Departments of Paediatrics and Pharmacology at ACSR Medical College and Government Hospital. A total of 1200 paediatric patients aged 1–18 years were included through simple random sampling (OPD: 900; IPD: 300). Prescriptions were analysed using WHO prescribing indicators. ADRs were assessed using the WHO-UMC causality assessment scale and Hartwig’s severity assessment scale. Statistical analysis was performed using SPSS version 19.

Results: Among the 1200 patients, 59% were males. Respiratory disorders (19.6%) and gastrointestinal disorders (15.3%) were the most common indications for antimicrobial use. Antimicrobials were prescribed in 63.9% of cases. Cephalosporins (33.3%), penicillins (16.7%), and aminoglycosides (13.3%) were the most commonly prescribed antimicrobial classes. The average number of drugs prescribed per encounter was 3.56. Injectable drugs were used in 53.7% of cases, while 78.5% of prescriptions were written using generic names. All antimicrobials were prescribed from the National Essential Drug List. ADRs occurred in 11.3% of patients, predominantly due to cephalosporins (67.6%), and ranged from mild to severe.

Conclusion: The study highlights overuse of injections and broad-spectrum antibiotics, with incomplete adherence to WHO prescribing indicators. Rational prescribing practices and strengthened antimicrobial stewardship are essential to reduce resistance and improve paediatric treatment outcomes.

Keywords:

Antimicrobials, Paediatrics, Drug Utilisation Study, Adverse Drug Reactions, WHO Prescribing Indicators, Antimicrobial Resistance, Rational Drug Use, Antimicrobial Stewardship

DOI

https://doi.org/10.70604/

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