Pattern of drug prescription in the pediatric intensive care unit of a tertiary care hospital with emphasis on antimicrobial utilization

Abstract

Background : Various therapeutic classes of drugs are used in children admitted to a pediatric intensive care unit (PICU) and among them antimicrobials are the most frequently prescribed agents. However, not infrequently, antimicrobials are used empirically. Objectives: The aim of the present study was to evaluate the drug utilization pattern in the PICU of a tertiary care hospital, particularly with regard to the antimicrobial agents. Methods: A prospective, observational study was carried out in the PICU for a period of 3 months. Demographic details, diagnoses and drugs given to all patients were recorded. Evaluation was made keeping in mind the World Health Organization antimicrobials prescription indicators. Results: Among the 2019 prescription items used in 223 children over a 3month period, the most commonly used class of drugs was antimicrobials (34.6%), followed by proton pump inhibitors (11.04%) and sedatives and anticonvulsants (10.94%). An infective diagnosis was made in 60.09% of patients. The average number of antimicrobial prescription per patient was 3.1± 2.9. The average duration of antimicrobial usage was 6.8±7.27 days and most of the time it was used empirically (4.47±2.43 days). Ceftriaxone was the most commonly prescribed antimicrobial agent in patients with both infective and non-infective diagnoses but the average length of antimicrobial treatment and the cost of antimicrobials per patient was significantly different between these two groups (p <0.05). Conclusions: Antimicrobial prescription protocols given by WHO need to be followed for their rational use to bring down the cost of treatment and reduce the occurrence of antimicrobial resistance.

Keywords

• antimicrobials
• prescription pattern
• picu