Drug Utilization Evaluation in Upper Respiratory Infection in Pediatric Population in North Indian Tertiary Hospital

Background: According to the WHO, around 5 million childhood deaths occur per year and around 20% of all childhood deaths are due to acute respiratory tract infections. Materials and Methods: A cross-sectional study was carried out in a tertiary care hospital for 6 months (December-May) on pediatric patients (age≤12 years) diagnosed with URTI. Data like demographic details, diagnosis, World Health Organization (WHO) prescribing indicators, different classes of drugs prescribed, antibiotic treatment, etc., were gathered from the pediatric Outpatient Department (OPD). Results: A total of 153 prescriptions were evaluated; of these, 84 (54.9%) were males and the rest, 69(45.1%), were females. Mainly, school children 89 (58.17%) of the age group between 6-12 years visited the outpatient pediatric department with commonly recorded clinical symptoms of fever and cough, accounting for 81% and 66.7%, respectively. The average number of drugs prescribed was 2.38 per prescription; commonly prescribed medication for the management of URTI was antipyretics 111(72.5%), antihistamines 94(61.3%), followed by antibiotics 55(35.9%). Amoxiclav (31.66%) and Cefixime (30%) were the common antibacterial prescribed. Moreover, it was observed that the antibiotics were prescribed without investigations for bacterial infections. Most medications (85%) were from the WHO model list of essential medicines; their generic name was prescribed by 36.43%. Conclusion: Symptomatic treatment was offered in most audited prescriptions and antibiotics were prescribed with no definite evidence of bacterial infection. Initiation of Antimicrobial Stewardship programs and National Action Plan on Antimicrobial Resistance (NAP-AMR) guidelines in healthcare institutes can help prescribers follow rational drug therapy.