title: Prescribing Pattern of Anti-malarial Drugs with Particular Reference to the use of Artesunate in Complicated Plasmodium Vivax Cases.
abstract: BACKGROUND
  In developing countries, Malaria has been found to be one of the most common cause of fever and morbidity, particularly among infants and young children. Therefore, its drug utilization studies should be carried out to know the rationality of treatment.
  
  
  OBJECTIVE
  To evaluate the use of antimalarial agents in children with a diagnosis of Malaria and visited to OPD & IPD Paediatric department of a tertiary care teaching hospital.
  
  
  METHODS
  This was a prospective six months study based on a Medication Utilization Form, which has been designed in consultation with the paediatrician. One hundred eighty three children <12 y of age were selected on the basis of inclusion and exclusion criteria.
  
  
  RESULTS
  Out of 183 patients, 110 were infected with Plasmodium falciparum (60.10%) and 73 with Plasmodium vivax (39.89%). Most of the patients were male, 56.83% and 43.16% were female patients. Most of the complicated cases were found from Plasmodium falciparum (n = 110) than Plasmodium vivax (n=15). In prescriptions with monotherapy, Artesunate (n=101) was found to be the most commonly prescribed drug and in prescriptions containing more than one drug, Artesunate - lumefantrine (n=125) combinations were frequently used. Most of the drugs were prescribed by oral route (n=285), than the parenteral route (n=140). The average number of drugs per encounter was 2.32 and only 4.50% drugs were prescribed by generic name. Average drug cost per prescription in complicated cases was found to be higher (185.5 INR) than uncomplicated cases (115 INR).
  
  
  CONCLUSIONS
  Artemisinin were used as first line drugs irrespective of the causative agent for malaria, which is not recommended, however has been found to be effective in complicated cases of Plasmodium vivax also. The cost of the prescription was higher. Interventions to rectify over prescription of injectables necessary to further improve rational drug use in our facility. Also, there should be an awareness program, especially in slum areas to cut down the transmission of disease.
authors: Assistant Professor, Department of Pharmacology, Gold Field Institute of Medical Science & Research Centre , Faridabad, India .
authors: Ashutosh Kumar
authors: AK
authors: Singh
authors: Assistant Professor, Department of Pharmacology, Gold Field Institute of Medical Science & Research Centre , Faridabad, India .
authors: Mohd Sajid
authors: MS
authors: Khan
authors: Associate Professor, Department of Pharmacology, Teerthanker Mahaveer Medical College & Research Centre , Moradabad, India .
authors: Farhan Ahmad
authors: FA
authors: Khan
keywords: Artesunate; Drug utilization study; Essential drugs; Lumefantrine; Malaria
references: Emerg Infect Dis. 2005 Jan;11(1):132-4
references: 15705338
references: Indian J Med Res. 1996 Jan;103:26-45
references: 8926025
references: Antimicrob Agents Chemother. 2002 Dec;46(12):3947-53
references: 12435700
references: Acta Trop. 2012 Mar;121(3):246-55
references: 22248528
references: Parasitol Today. 1996 Oct;12(10):399-401
references: 15275291
references: Emerg Med Pract. 2014 May;16(5):1-23; quiz 23-4
references: 25207355
references: Indian J Med Res. 2012 Dec;136(6):907-25
references: 23391787