Evaluation of Symptomatic Treatment Approaches of Pediatricians for Pediatric Patients with Upper Respiratory Tract Infection Regarding to Rational Drug Use

Abstract

Introduction: Prescribing a large number of drugs for symptomatic treatment of upper respiratory tract infection (URTI) can cause more frequent drug interactions and an increase in undesirable side effects in pediatric patients. The aim of this retrospective study is to evaluate the drug prescriptions for symptomatic treatment to pediatric patients diagnosed with URTI in terms of rational drug use. Materials and Methods: Fourteen pediatric outpatient clinics of Sanliurfa Training and Research Hospital were included in the study. The number of samples was determined as 1064. The first 76 prescriptions of the pediatricians written for patients diagnosed as URTI were selected retrospectively by using the Hospital Information Management System. Results: There was an average of 4 and a maximum of 9 drugs, whereas the number of active substances was between 6 and 19 in prescriptions. Analgesics-antipyretics (86.7%) and antibiotics (69.1%) were most prescribed, followed by decongestants (47.9%) and antihistamines (47.1%). Analgesic-antipyretics (36.4%) was the most preferred drug group among the drugs used in symptomatic treatment whereas antiseptics was the least (0,9%). Active ingredients prescribed more than once due to combined preparations were analgesics (36.2%), expectorants (18.7%), decongestants (16.5%), antihistamines (8.8%) vitamins (5%) respectively. Antihistamines (21.8%), decongestants (21.2%), and cough suppressants (16.8%) were used at inappropriately high doses. Decongestants were used mostly in inappropriate dosing interval, compared to other groups (20.8%). When assessed according to physician prescriptions, drugs used in symptomatic treatment, drug combinations from the same group, preference for local or systemic use, and inappropriate doses of antihistamines and decongestants were statistically different among physicians. Conclusion: This study shows that some of the specialist physicians currently prescribe incompatible with the principles of rational drug use in the symptomatic treatment of children with a diagnosis of URTI. Continuous in-service training could increase the awareness of physicians on this subject and keep their knowledge up-to-date. Additionally, establishing a warning system or making limitations during e-prescription may also be useful.