1 Drug utilization study in the management of acute diarrhoea in the paediatrics department at a tertiary health care institution- A prospective study.

Abstract : AIMS AND OBJECTIVES: To evaluate the drug utilization pattern and to assess the use of zinc in the management of acute diarrhoea in the Paediatrics department at a tertiary health care institution. MATERIALS AND METHODS: This was a Prospective hospital based study which was carried out in the Paediatrics Department at Gauhati Medical College and Hospital, Guwahati after obtaining permission from the Institutional Human Ethics Committee. About 80 prescriptions were analyzed during the study period of 6 months. All the patients of either sex (male/ Female) between 0-5years age who were coming to the Paediatrics department (outdoor and indoor) suffering from any type of diarrhoea and was prescribed different drugs were included in the study. Patients coming to the Paediatrics department not suffering from diarrhoea were excluded from our study. RESULTS: Out of 96 inpatients, 84 patients were admitted, cured and discharged, while 12 patients were seen as outdoor patient and were not admitted. No complication, deaths or ADR were reported during the hospital stay. Out of these, majority 51 (53.1%) were females. The mean age of the patients was 1.92 years. Most patients (59.4%) were between 1-3years of age. Majority 62.5% were suffered from acute watery diarrhea. Out of 96 patients, 33 (34.4%), 54 (56.2 %) and 9 (9.4%) were diagnosed with no, some and severe dehydration, respectively. No reports on routine examination and culture of stool were obtained. A total 312 drugs were prescribed in these inpatients. Out of the various drugs prescribed, 93 patients (96.9%) were prescribed rehydration fluids like ORS, 81 patients (84.4%) were given intravenous fluids. Other frequently prescribed drugs were Zinc to 96 patients (100 %) followed by antimicrobials in 39 patients (40.6%) and probiotics in only 3 patient (3.1%).Only Two different antimicrobials were prescribed; among these ceftriaxone (30) was the most prescribed followed by metronidazole (9). Out of the 312 formulations prescribed, 102 (32.7%) were oral formulations and 210 (67.3%) were intravenous injections. The mean number of drugs prescribed per patient was 3.25 (range 1 to 4). Regarding utilization of zinc preparations; they were prescribed in 100 % inpatients as monotherapy (mostly zinc gluconate) regardless of any age or any type of diarrhoea. CONCLUSION: The findings of this study suggested that there is a relatively rational approach to oral and parenteral rehydration therapy, antimicrobials and FDC.

Keyword : drug utilization, paediatrics, acute diarrhoea, zinc, antibiotics