Prescribing pattern of drugs in upper respiratory tract infections in pediatric out patients

Abstract

Background: Upper respiratory tract infections are the most frequently occurring illness of childhood. The common types of upper respiratory tract infections are common cold, rhinitis, laryngitis, pharyngitis, otitis media and sinusitis. Common misuse of antimicrobial agents is seen in infections caused by viruses, which are self-limited and they do not respond to the currently available anti-infective agents. Methods: A prospective observational study was conducted at pediatric out-patient department of Basaveshwara Medical College Hospital and Research Centre, Chitradurga for a period of six months. The data was collected from outpatient record in a suitably designed individual case record form of the patients diagnosed with upper respiratory tract infection. Results: A total of 120 patients aged less than 13 years were collected from the paediatric outpatient department of a tertiary care teaching hospital. The most common diagnosis was nonspecific upper respiratory tract infections (49.1%). Only 10 drugs were prescribed from the essential drug list. Amongst all drug class, respiratory drugs were prescribed in more (29%), antihistamines (24.6%), antimicrobials (24.3%), Non-steroidal anti-inflammatory drugs (18%) and nasal drops (4.1%). In antimicrobials, amoxicillin + clavulanic acid (45.8%) was the highly prescribed combination. The main drug interactions were between chlorpheneramine and terbutaline. Conclusions: Antibiotic prescriptions were inappropriate in acute self-limiting upper respiratory tract infection. Antibiotics are over prescribed for paediatric upper respiratory tract infections. Amoxicillin with clavulanic acid combination were preferentially prescribed. Doctors should be educated on more appropriate and cost effective prescribing.