Prescribing practices for pediatric out-patients: A case study of two teaching hospitals in Nigeria

Purpose: The objective of this study was to evaluate drug utilization pattern in the pediatric departments of two tertiary health facilities in Nigeria using WHO core prescribing indicators.
Methods: Using a cross-sectional retrospective study approach, prescriptions randomly selected for a period of 6 months from the pediatric out-patient departments of two tertiary hospitals: Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka and Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi in South- Eastern Nigeria were assessed. Prescribing indicators as listed by WHO were calculated and analyzed using SPSS version 20.
Results: A total of 750 prescriptions (450 from NAUTH and 300 from COOUTH) containing 2,739 drugs were assessed. The mean number of drugs prescribed per encounter (mean ± SD) at NAUTH was 3.5 ± 0.9 and 3.8 ± 1.1 in COOUTH. The percentage of antibiotics prescribed per encounter in COOUTH and NAUTH were 72.3 and 77.1 %, respectively, whereas drugs prescribed by generic names were 61.7 and 64.2 %, respectively. Injections prescribed per encounter were above acceptable range, and percentages of drugs prescribed from essential medicine lists in the two hospitals were > 85 %.
Conclusion: This study identified irrational use of antibiotics, polypharmacy, non-adherence to generic prescribing and high use of injections in both hospitals. The need for improvement in prescription patterns is underscored.

Keywords
Prescription pattern; Pediatric outpatients; WHO indicators; Irrational use; Antibiotics; Polypharmacy