Drug Utilisation Study in Paediatric Patients with Acute Exacerbation of Bronchial Asthma Hospitalised in a Tertiary Care Teaching Hospital

ABSTRACT Introduction: Bronchial asthma is a heterogenous disease in children. It often leads to acute exacerbations resulting in increased Emergency Department (ED) visits, hospital admissions and school absenteeism among them. Irrational prescribing practices are quite prevalent among children. This highlights the importance of Drug Utilisation Studies (DUS) that are essential to investigate the pattern of drug use, thereby ensuring cost-effective health care and rational use of drugs. Aim: To evaluate drug utilisation pattern for the treatment of acute asthma exacerbations in children hospitalised in a tertiary care teaching hospital. Materials and Methods: This cross-sectional, observational study was conducted in the in-patient, Department of Paediatrics for a period from December 2017 to March 2019. A total of 30 children aged 1-17 years of either sex hospitalised for acute asthma exacerbations were enrolled in the study. Parameters like demographic profile and pattern of drug use were assessed. The collected data was presented as percentages, Standard Deviation (SD) and mean. Results: Results revealed that most commonly affected age group was 1-5 years (43.33% of total subjects) with female predominance. 13.33% children presented a positive family history of asthma. To manage acute exacerbations of asthma, all the patients received anti-asthmatic drug combinations and inhalational route was preferred. Corticosteroids and Short Acting β2 Agonists (SABA) were the most commonly prescribed drug classes. SABA (Levosalbutamol) was prescribed mainly through inhaled route (66.66%). 90% children received inhaled budesonide while IV Hydrocortisone was used in 86.66% cases of exacerbation. Combination of inhaled SABA + Ipratropium bromide was given in 36.66% patients. Montelukast was prescribed in 33.33% children as an add-on therapy. Average duration of hospital stay for the present episode was 3.96±1.04 days. Average number of drugs per prescription was 10.13. None of the drug was prescribed by generic name and antibiotics were used in 96.66% patients. Conclusion: The observed drug utilisation pattern in the present study does not completely comply with the recommendations of standard treatment guidelines for asthma. High prescribing of antibiotics, polypharmacy and prescribing by brands are issues that need to addressed which will ensure rational use of drugs in future.