Nephrotic syndrome (NS) is one of the common yet challenging childhood disease. Treating NS with immunosuppressants like corticosteroids is typically effective. However, there are significant evidences which displayed resistance patterns to the former drugs. Here in this case, a male patient came to the nephrology department with the history of steroid dependant nephrotic syndrome with complaint of its infrequent relapse. The condition was complicated since, the patient was on multiple steroids even after which there were recurrent episodes of syndrome. Considering the status, Mycophenolate mofetil was added as a supportive treatment for the management of the disease along with steroids, still the outcome was unremarkable. Hence, rituximab was ordered (four cycles). The outcome this time was appreciable, rituximab administration produced a positive result. No events were recorded during the treatment duration.

Background: The study aimed to get drug utilization pattern using WHO prescribing indicators in pediatric patients. Methods: It was an observational prospective study carried out in pediatric in-patients with a sample size of 280 patients based on inclusion, and exclusion criteria for a period of 6 months. The study data were collected using patient case record and analysis was done. Results: Out of 280 patients data collected, majority of patients were in the gender male category 168 (60%) and many were from the age group of early childhood (1-5 years) 126 (45%). Respiratory tract infections were the major diagnosis made among the sample size. The drug class commonly prescribed were oral antibiotics 261 (28.38%). The average number of drugs per prescription were 3.28%. Among the total number of prescription percentage of drugs prescribed by generic name and antibiotics were 2.7%, 76.07%. Percentage of patients prescribed with injection were 79.28%. Conclusions: This study highlights WHO prescribing core indicators in evaluating the usage of rational prescription. It helps in reinforcing rational prescribing practices and increases awareness among physicians and medical students. Irrational prescriptions may result in harmful events. A rational prescription should follow the standard treatment guidelines of WHO. The assessment of these indicators can also help us to decrease the cost burden on the patient. Continuous education with focus on rational drug usage and evidence-based medicine can further increase the understanding and improves health care policies.