Drug utilization study in dengue infection in a tertiary care hospital

Background: Dengue fever (DF) is a serious public health problem, gaining global attention because of its morbidity and mortality. Less studies on Drug utilization pattern of DF in India. The present study was undertaken to analyze Drug utilization pattern of dengue infection in a tertiary care hospital.Methods: A prospective cross-sectional study was conducted for a period of 2 months in a tertiary care hospital and the data was analyzed by using various drug use indicators.Results: A total of 52 prescriptions were analyzed. Male and female were (46.16%, 53.84%), A total of 330 drugs were prescribed. 86 (26.06%) antibiotics, 70 (21.21%) antipyretics, 51 (15.46%) antacids, 19 (5.76%) multivitamins, 52 (15.76%) anti-emetics and 52 (15.76%) papaya leaf extract was prescribed. 84 (25.46%) oral and 246 (74.54%) injectable drugs. IV-fluids given to all patients. 10 (19.24%) were given blood transfusion. 6.17 drugs per prescription. 96% drugs were prescribed by brand names. High DDD for drugs like diclofenac (184), doxycycline (115), metronidazole (2.5), pantoprazole (161.5), rabeprazole (34.6), ondansetron (200) was observed.Conclusions: Most commonly used drugs are antipyretics, antibiotics, antacids, antiemetic, papaya leaf extract. As the incidence of DF is increasing with epidemics, demand for specific treatment guidelines is in great need. Early recognition of the disease, with a rational approach in case management leads good clinical outcome

A case report of life threatening Dapsone Hypersensitivity Syndrome

Dapsone is widely used for a variety of infections, immune and hypersensitivity disorders. However, the use of Dapsone may be associated with a plethora of adverse effects, the most serious being Dapsone Hypersensitivity Syndrome (DHS) wherein the patient typically presents with a triad of fever, skin eruption and internal organ involvement, that occurs during first 2 to 8 weeks of initiating the treatment. The incidence of DHS ranges from 0.5% to 3%.  Here we report a case of severe life threatening Dapsone induced hypersensitivity reaction in a 21year old female who presented with high grade fever, generalized lymphadenopathy, skin rash and hepato-splenomegaly. This condition is best approached with immediate discontinuation of offending drug and prompt administration of oral or IV glucocorticoids. The case is being reported to emphasize the need for timely diagnosis and prompt treatment for successful outcome as it can cause irreversible organ damage or death if untreated early

Prospective observational study of drug utilization in neonatal seizure at a tertiary care hospital with Pharmacoeconomics

Background: Seizures are the most common indicator of significant neurologic dysfunction in neonatal period with incidence of 11.7/1000 live births. Phenobarbitone is used as first line of treatment since 1900s. Newer anti-epileptic drugs (AED) available are Levetiracetam, Topiramate etc. Present study focused on utilization pattern of AED, treatment outcomes and to study economic burden of disease.Methods: An observational study was done on 100 neonates admitted to Neonatal Intensive Care Unit in Basaveshwara hospital, Kalaburagi (June 2016-May 2017). Prescription data was entered into specially designed proforma, WHO core indicators were determined. The data was analyzed using descriptive statistics and presented as means and percentages.Results: Majority of neonates were male (58%) and 63% were diagnosed with subtle seizure. Out of 458 drugs prescribed, 201 were antiepileptics. 41% cases were successfully managed by monotherapy. Most commonly used drug was phenobarbitone (82%) and phenytoin (31%). Leviteracetam, newer AED was used in 3 refractory cases. The major combination of drugs used was Phenobarbitone-Phenytoin (24%). AED were rationally prescribed, but antibiotic was over-utilized(68%). 31% cases had adverse drug reaction. On average per prescription, number of drugs used were 4.6 and drug cost was Rs.3803/-. The total cost of illness per patient was Rs.16363/-.Conclusions: AED utilization in neonatal seizures was in accordance to guidelines, with phenobarbitone being extensively used despite its potential neurotoxicity. The utilization of newer AED would increase if clinicians are supported with the safety and efficacy data. Although monotherapy was preferred with respect to AED, antibiotics were highly prescribed; hence awareness is needed to curb this practice