DRUG PRESCRIBING PATTERN IN NEONATAL INTENSIVE CARE UNIT AT TERTIARY CARE HOSPITAL, MANDYA: A RECORD BASED STUDY.

Dr. Divya Shree N.*, Rose Rebecca T. and Rasigai Priya S.

ABSTRACT

Background: As per WHO definition, a newborn infant or neonate is a child under 28 days of age. The neonatal period (≤28 days old) is a critical phase of human development with the newborn having to adjust considerably to various physiological states in its new environment. A neonatal intensive care unit (NICU) is a highly specialized unit that provides high-quality skilled care to critically ill newborn infants and premature and low birth weight infants. Apart from facilities for continuous clinical and biochemical monitoring, the neonatal intensive care unit involves the use of a wide range of medications. Neonatal drug handling is significantly different from that of adults. Such differences are due to rapid physiological changes that take place during the early months of life leading to alterations in various pharmacokinetic and pharmacodynamic variables, which leads to various adverse drug reactions. Prescribing pattern studies are powerful exploratory tools to ascertain the role of drugs in society. In a tertiary care center, prescribing is expected to be judicious, appropriate, safe, effective, and economical. Objective: To describe the prescribing pattern of drugs in the neonatal intensive care unit at MIMS, Mandya. Methodology: This was a record-based study on drug prescribing patterns in the neonatal intensive care unit at MIMS, Mandya. The information about drug prescribing patterns was obtained from patients' case sheets and details are documented and subjected to suitable statistical methods. Results: Among 200 neonates under study, 56% were males and 44% were females. There were 15% preterm born neonates. Neonatal sepsis (23.5%), low birth weight (17%), and jaundice (13.6%) were the common indications for admission. The total number of drugs prescribed was 982 with an average number of drugs per neonate at 4.91. In that, anti-infectives (43.07%) were more frequently prescribed drug class followed by nervous system drugs (5.80%) according to the WHO-ATC classification system. Among anti-infectives more commonly prescribed drug was amikacin (38.6%) followed by amikacin and clavulonic acid combination (26.2%). Among 200 prescriptions 181 contained antibiotics, and 75 % of prescriptions contain 2 antibiotics. The parenteral route of administration is frequently used (44%), followed by oral (26.6%). 42% of drugs were prescribed by generic names 61.9% were drugs prescribed from the essential medicine list (Children) and59.5% were drugs prescribed from the National list of essential medicine of India. Conclusion: Our study was mainly focused on prescribing patterns of drugs in the Neonatal Intensive care unit (NICU) and common diseases in neonates. Evaluation of the prescription pattern of drugs can improve the quality of prescription therefore they need to be done periodically.

Keywords: Neonates, Neonatal intensive care unit, Prescription pattern, Rational drug use.