Assessment Of Medication Use Patterns For Managing Neonatal Sepsis At A Tertiary Care Hospital
Keywords:
Neonatal sepsis, drug usage analysis, antibiotics, WHO indicators, NICU, antimicrobial resistance, ADRsAbstract
Background: Neonatal sepsis remains a critical health Challenge in developing countries, contributing heavily to infant illness and death. Effective management on the judicious use of medications, particularly antibiotics, and strict adherence to antimicrobial stewardship principles are critical for improving outcomes. This study investigates how medications are utilized, identifies adverse drug reactions (ADRs), and evaluates clinical results in neonates diagnosed with sepsis at a tertiary care hospital in Coimbatore, Tamil Nadu.
Methods: Study was prospective and observational review of patients record in the hospital.400 neonates admitted to the NICU. Cases were categorized into early-onset (EOS) and late-onset sepsis (LOS). Prescribing trends were reviewed using WHO indicators, and ADRs were assessed using the WHO-UMC causality scale and the Naranjo algorithm.
Results: Males comprised 53.75% of the study group, with an 85.25% survival rate. EOS was prevalent among preterm and home-born neonates. A total of 1,428 drugs were prescribed, averaging 3.57 medications per neonate. Antibiotics were administered in 60.3–100% of cases, most commonly ampicillin, gentamicin, and cefotaxime. Injectable drugs accounted for 86.97% of prescriptions. Between 71.2–73.33% of drugs were from the Essential Medicines List, and 78–91% were prescribed generically. ADRs were recorded in 2.5% of cases, most categorized as "possible." The most frequently isolated microorganism was Staphylococcus aureus.
Conclusion: Initial antibiotic prescribing was generally appropriate, though the findings point to the necessity for more consistent prescribing practices, better ADR documentation, and stricter adherence to essential medicine guidelines
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References
Budnoor Jayaram K, D U, Bhushal P. Drug utilization pattern in a neonatal intensive care unit at tertiary care hospital attached to a medical college in Southern Karnataka, India. International Journal of Contemporary Pediatrics.2019;6(3):1010–4. doi:10.18203/2349 3291.ijcp20190975
Brijal SP, Amita RK, Divyesh BS, Kiran GP. Drug utilization study in neonatal intensive care unit at tertiary hospital, Rajkot, Gujarat: A prospective study. World J Pharm Pharm Sci.2015;4(7):2034-42.
Agrawal P, Singhal A, Agrawal VK. Drugs utilization study in neonatal sepsis in tertiary care hospital. Asian J Pharm Clin Res. 2022 Nov;15(11):1–4. doi:10.22159/ajpcr. 2022.v15i11.45841
Agarwal R, Deorari AK, Paul VK. AIIMS protocols in neonatology. Delhi: CBS Publishers; 2014. Available from: https://www.newbornwhocc.org /2014_pdf/ Neonatal% 20sepsis%202014.pdf [cited 2022 Mar 4].
Demeke B, Molla F, Assen A, Melkam W, Abrha S, Masresha B, et al. Evaluation of drugs utilization pattern using WHO prescribing indicators in Ayder referral hospital, Northern Ethiopia. Int J Pharm Sci Res. 2015;6:343–6.
World Health Organization. WHO model list of essential medicines for children. 4th ed. Geneva: World Health Organization; 2013. Available from: https://www.who.int/medicines/publications/essentialmedicines/en/index.html [cited 2021 Oct 24].
Gayathri A, Patil B, Vardhamane SH, SantoshKumar J, Kanaki AR. A prospective study of prescribing pattern of drugs in NICU at Basaveshwar teaching and general hospital, Gulbarga, Karnataka. Int J Pharmacol Ther. 2014;25:26–31.
Sharanappa YV, Lakshminarayana K, Acharya S. Pattern of drug utilisation in Neonatal Intensive Care Unit in a tertiary care hospital. Int J Biol Med Res. 2014;5:582–4.
Suryawanshi S, Pandit V, Suryawanshi P, Panditrao A. Antibiotic prescribing pattern in a tertiary level neonatal intensive care unit. J Clin Diagn Res 2015;9:FC21-4
Suryawanshi S, Pandit V, Suryawanshi P, Panditrao A. Antibiotic prescribing pattern in a tertiary level neonatal intensive care unit. J Clin Diagn Res 2015;9:FC21-4
Suryawanshi S, Pandit V, Suryawanshi P, Panditrao A. Antibiotic prescribing pattern in a tertiary level neonatal intensive care unit. J Clin Diagn Res 2015;9:FC21-4
Suryawanshi S, Pandit V, Suryawanshi P, Panditrao A. Antibiotic prescribing pattern in a tertiary level neonatal intensive care unit. J Clin Diagn Res. 2015;9(2):FC21–4.
Namdarifar F, Raouf S, Shahraki EM, Murthy NBS. Drug utilization study in neonatal intensive care unit at tertiary care hospital. Rev Assoc Med Bras (1992). 2021;67(8):1163–8. doi:10.1590/1806-9282.20210831.
Chauthankar SA, Marathe PA, Potey AV, Nanavati RN. Drug utilization in neonatal intensive care unit of a tertiary-care hospital in Mumbai, India. Indian J Pediatr. 2017;84(10):812–6. doi:10.1007/s13312-017-1184-1.
Rahul S, Ali S, Doddayya H. Drug utilization pattern in neonatal intensive care unit in a tertiary care teaching hospital – a retrospective study. Hum J. 2024 Jun;30(6).
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