Prescribing patterns among paediatric inpatients in a teaching hospital in western Nepal

Infants and children constitute a large proportion of the population in developing countries. In Nepal, studies on drug use patterns in the paediatric age group are lacking in hospitals in the western region. The present study was carried out to obtain demographical information and information on the prescribing patterns of drugs. The antibiotic sensitivity patterns of commonly-isolated micro-organisms and the mean cost of drugs were obtained.

The study was carried out over a four-month period (December 1, 2003 to March 31, 2004) at the Manipal Teaching Hospital, a tertiary care hospital in Pokhara, western Nepal. The case records of patients discharged from the paediatrics ward during the study period were analysed. Mean number of drugs prescribed was calculated. The percentage of admissions that were prescribed antibiotics was determined.

356 patients were admitted during the study period, of which 228 were male. The median duration of hospitalisation was four days. The mean number of drugs prescribed per admission was 4.5. 789 drugs (48.9 percent) were prescribed by the parenteral route. Antibiotics were prescribed in 249 admissions (69.9 percent). Staphylococcus aureus, Escherichia coli, and Acinetobacter species were the common organisms isolated, and were resistant in some cases to the commonly-used antibiotics. The mean (+/- standard deviation) cost of drugs per admission was 5.4 (+/-1.6) US dollars.

Prescribing by generic name should be encouraged. Use of parenteral antibiotics was high and route conversion programmes should be instituted. Use of antibiotics for predominantly viral infections should be reduced. Treatment guidelines for common conditions should be formulated.