Research Scholar Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research Mysuru, India
Background: Morbidity and mortality is high among neonates due to preterm, low birth weight, susceptibility of multiple diseases and complications. It require wide ranges of drug therapies that increases the risk for irrational usage of drugs and drug related harm. The data on the drug utilization and their evaluation among neonates admitted to the hospital is limited in a developing countries.
Objectives: This study aimed to determine the drug utilization pattern and to evaluate appropriateness of drugs usage among neonates in a neonatal intensive care unit (NICU).
Methods: A prospective cross-sectional was conducted at the department of Pediatrics, NICU in a tertiary care teaching hospital, south India for 12 months. Patients of either gender, age ≤28 days and admitted in a hospital more than 24 hours were included in this study. Study was approved by Institutional human ethical committee. Clinical pharmacist actively participated in daily ward round with Neonatologist-led team to identify the study eligible patients and to collect study relevant data in a suitably designed data collected form. Collected data were critically evaluated for drug utilization pattern using WHO anatomical therapeutics chemical (ATC) and also evaluated for inappropriate usage of drugs. Collected data were transferred into Microsoft excel and statistical analysis was performed using SPSS V25.
Results: A total of 616 neonates were admitted in NICU and 565 of them were enrolled as per the study criteria .Reason for exclusion of neonates was stay less than 24 hours (51). Of them, 328 (58%) were males. The mean age of neonates was 3.2 (SD±0.93) days. Majority 378 (66.9%) of neonates were admitted soon after birth to the NICU. Among them, preterm 353 (62.4%), neonatal sepsis 235 (41.5%) and respiratory distress 110 (19.4%) were the major reasons for the neonatal admission. A of total 1794 drugs (3.17 drugs per neonate) was prescribed among study patients. Drug prescribed in preterm and low birth weight was noticeably high. The most frequently prescribed drug classes were antimicrobial agents 1250 (69.67%) followed by central nervous system (CNS) agents 287 (16%). In antimicrobial agents, the Piperacillin + Tazobactam 587 (46.96%) and Gentamicin 293 (23.44%) were the most commonly prescribed drugs.The study, also found that Inappropriate usage of drugs was 93. This were related to dose 49 (52.68%) and duration 32 (34.40% ).The overall mortality rate in the study population was found to be 36 (6.37%).
Conclusions: The utilization of antibiotics and inappropriate use of drugs were high in neonates. Thus, adopting multidisciplinary treatment approaches and implementing drug therapy treatment guidelines strictly can enhance the rational and appropriate usage of drug therapy among neonates.
