Drug Utilization Study in Neonatal Intensive  Care  Unit at Rural Tertiary Care Hospital.

Choure, Mangal Kishanrao; Jadhav, Rakesh R.; Padwal, Sudhir L.

doi:10.22159/ajpcr.2017.v10i4.16111

Cited by 10 publications

(8 citation statements)

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“…It shows that average number of drugs per neonate as 3.57 which is similar to a study by Choure et al, and yet another reported average number of drugs per encounter as 4.8. 1,9 Of the total 1428 drugs prescribed during the study period, majority of prescriptions were accounted by antibiotics (60.36%), followed by CNS drugs (7.84%) and alimentary system (4.83%) which is comparable to study done Neubert et al, where 90% of the drugs prescribed were anti-infectives followed by nervous system drugs and respiratory drugs. 3 The total encounter of antibiotic were 862 which accounts 60.36% of total drug prescription which is similar to a study done by Brijal et al, where 65.07% of neonates were exposed to antibiotics and yet another study showed 64.5% of antibiotic exposure.…”

Section: Discussionsupporting

confidence: 79%

“…Out of 400 neonates admitted in NICU, 53.75% were male which is in consistent with study done by Brijal et al, and Choure et al, in which 60.92% and 54.3% were male neonates respectively. 1,7 This shows that the gender discrimination in term of access to public health care and need for immediate awareness against gender discrimination in early stage of life.…”

Section: Discussionmentioning

confidence: 99%

“…Apart from facilities for continuous clinical and biochemical monitoring, neonatal intensive care unit involves use of a wide range of medications. 1 Jayaram KB et al Int J Contemp Pediatr. 2019 Very less information is available on pharmacokinetics and pharmacodynamics of drugs in newborn and infants because they are discouraged or not included in drug trials.…”

Section: Introductionmentioning

confidence: 99%

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Drug utilization pattern in a neonatal intensive care unit at tertiary care hospital attached to a medical college in Southern Karnataka, India

Jayaram

Usha

Bhushal³

2019

Int J Contemp Pediatr

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Background: Neonates and in particular preterm neonates belongs to the most vulnerable population. A neonatal intensive Care Unit (NICU) is a highly specialized unit that provides high quality skilled care to critically ill new newborn, premature or low birth weight babies. Apart from facilities for continuous clinical and biochemical monitoring, NICU management involves the use of wide range of medications. Irrational prescription of drug is common in clinical practice, important reason being lack of knowledge about drug prescription. Developing countries have limited funds available for health care and drugs so it becomes very important to prescribe drugs rationally. The present study was done to find out the drug utilization pattern and improve the rational use which aids in the improvement of neonatal care. Methods: The study was retrospective study in NICU of tertiary care hospital attached to MIMS, Mandya for a duration of 6 months. Data extraction sheet were used to collect the information regarding demographic details, maternal and delivery details, indication for admission, final diagnosis and medications administered. Data collected were evaluated for the category of prescribed, based on World Health Organization Anatomical Therapeutic Committee (WHO classification system and were analyzed using SPSS. WHO drug utilization core indicators were also evaluated.Results: Among 400 neonates admitted in NICU during the study period, 53.7% were males and 46.2% were females. There were 29.7% preterm born neonates. The maximum number of neonates were admitted in early neonatal period (87.25%). Neonatal sepsis (37.9%) and Birth asphyxia (11.6%) were the most common indications for admission. The total number of drugs prescribed was 1428 and the average number of drugs per neonate was 3.57. Preterm (<37weeks) and low birth weight (<2.5Kg) were exposed to significantly higher number of drugs. The most frequently prescribed therapeutic class of drugs was anti-infectives (60.36%), followed by drugs of central nervous system (7. 84%). Among the anti-infectives, the most commonly prescribed drugs were Ampicillin (59%), followed by gentamycin (42.5%). High end antibiotics like carbapenems, colistin’s and linezolid were used in less than 5% of cases.Conclusions: Drug use in neonates should be minimal and focus on the importance of therapeutic treatment guidelines establishment in hospital to control the over usage of antibiotics.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Drug utilization pattern in a neonatal intensive care unit at tertiary care hospital attached to a medical college in Southern Karnataka, India

Jayaram

Usha

Bhushal³

2019

Int J Contemp Pediatr

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“…Other characteristics of studies that reported a mean number of medications without reporting prevalence included evaluating multiple drugs/classes and being in international settings (Table S3). Table S3 also shows the rest of the studies that reported prevalence or average number of medications.…”

Section: Resultsmentioning

confidence: 99%

Variation of the prevalence of pediatric polypharmacy: A scoping review

Baker

Feinstein

et al. 2019

Pharmacoepidemiology and Drug

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Purpose To examine the range of prevalence of pediatric polypharmacy in literature through a scoping review, focusing on factors that contribute to its heterogeneity in order to improve the design and reporting of quality improvement, pharmacovigilance, and research studies. Methods We searched Ovid Medline, PubMed, EMBASE, CINAHL, Ovid PsycINFO, Cochrane CENTRAL, and Web of Science Core Collection databases for studies with concepts of children and polypharmacy, along with a hand search of the bibliographies of six reviews and 30 included studies. We extracted information regarding study design, disease conditions, and prevalence of polypharmacy. Results Two hundred eighty‐four studies reported prevalence of polypharmacy. They were more likely to be conducted in North America (37.7%), published after 2010 (44.4%), cross‐sectional (67.3%), in outpatient settings (59.5%). Prevalence ranged from 0.9% to 98.4%, median 39.7% (interquartile range [IQR] 22.0%‐54.0%). Studies from Asia reported the highest median prevalence of 45.4% (IQR 27.3%‐61.0%) while studies from North America reported the lowest median prevalence of 30.4% (IQR 14.7%‐50.2%). Prevalence decreased over time: median 45.6% before 2001, 38.1% during 2001 to 2010, and 34% during 2011 to 2017. Studies involving children under 12 years had a higher median prevalence (46.9%) than adolescent studies (33.7%). Inpatient setting studies had a higher median prevalence (50.3%) than studies in outpatient settings (38.8%). Community level samples, higher number and duration of medications defining polypharmacy, and psychotropic medications were associated with lower prevalence. Conclusions The prevalence of pediatric polypharmacy is high and variable. Studies reporting pediatric polypharmacy should account for context, design, polypharmacy definition, and medications evaluated.

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“…On the other hand, low birth weight and preterm neonates are fragile and vulnerable and they demand high level of skills and technology in a special care nursery or neonatal intensive care unit (NICU) for their intact survival. Apart from high mortality, many avoidable disabilities such as cerebral palsy, mental subnormality, learning disabilities, and recurrent seizures have their origin in perinatal period [3,4]. It is encouraging to note that neonates with a birth weight of 1 kg had a mortality of 95% in 1960 and now have 95% chances of survival.…”

Section: Introductionmentioning

confidence: 99%

Clinical Profile and Outcome of Neonates Admitted to a Secondary-Level Neonatal Intensive Care Unit in North India

Yousuf

Tali

Hussaın³

2017

Asian J Pharm Clin Res

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Objectives: The objective of this study was to evaluate the performance of a secondary-level neonatal intensive care unit (NICU). Methods:A total of 336 neonates were enrolled in the study. Their clinical profiles at admission and final outcomes were recorded in a predesigned pro forma.Results: Hyperbilirubinemia, sepsis, and perinatal asphyxia were the most common reasons for admission. Eighty-five percentage of the neonates could be managed in secondary-level newborn unit with comparable mortality and mortality to a tertiary-level newborn care unit. Conclusion:Strengthening of secondary newborn care units is a viable option that will help to decrease the burden of tertiary-level NICUs.

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Drug Utilization Study in Neonatal Intensive Care Unit at Rural Tertiary Care Hospital.

Cited by 10 publications

References 4 publications

Drug utilization pattern in a neonatal intensive care unit at tertiary care hospital attached to a medical college in Southern Karnataka, India

Drug utilization pattern in a neonatal intensive care unit at tertiary care hospital attached to a medical college in Southern Karnataka, India

Variation of the prevalence of pediatric polypharmacy: A scoping review

Clinical Profile and Outcome of Neonates Admitted to a Secondary-Level Neonatal Intensive Care Unit in North India

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