Prescription Pattern in Neonatal Intensive Care Unit of Tertiary Care Teaching Hospitals of Birgunj, Nepal.

Abstract

Introduction: Neonates admitted to neonatal intensive care units are subjected to wide range of medications so drug utilization studies provide a glimpse of ongoing treatment trend, identifying and avoiding side effects and promoting rationale use of medications. This study was conducted with an objective to assess the drug utilization pattern among neonates admitted at tertiary health care centres in Birgunj.

Materials and Methods: A cross sectional observational study was conducted at two tertiary hospitals of Birgunj for three months. Consecutive sampling method was applied and the prepared Performa contained demographic details, mode of delivery, duration of hospital stay, diagnosis, name of the drugs used, route of administration and use of generic name. Drug utilization among neonates was assessed by using World Health Organization Anatomical Therapeutic Chemical classification (WHO-ATC) and WHO core prescribing indicators. Descriptive statistics like mean ± SD, frequency and percentage were used to evaluate the data.

Results: Out of 270 neonates, preterm were 113 (41.85%), male were 147 (54.44%) and 109 (40.37%) were of normal birth weight. The neonates  diagnosed with neonatal sepsis were 86 (31.85%), neonatal sepsis with  respiratory distress syndrome were 51 (18.89%), and neonates with Meconium aspiration syndrome were 34 (12.59%). Total number of drugs used were 1153 out of which anti-infective drugs were 667 (58.76%), nervous system 249 (21.60%), cardiovascular system 81 (7.03%), respiratory system 67 (5.81%) and alimentary system 36 (3.12%). The average number of drugs prescribed per neonate was 4.27. The percentage of prescriptions containing antibiotics was 95.19 and 85.43% of drugs were prescribed from Nepalese Essential Drug List.

Conclusion: Our study findings suggest a high number of drugs prescribed per neonate and extensive use of antibiotics. Policies should be implemented to prevent the overuse of drugs and reduce antibiotic resistance and financial burden. Therefore, therapeutic drug monitoring, promotion of the rational use of medications and implementation of antibiotic stewardship programs are needed.