Drug utilisation pattern of antihistamines in upper respiratory tract infections in paediatric patients


Drug utilisation
Paediatric patients
Upper respiratory tract infections

How to Cite

Bharati, J. P., Ulak, S. ., Keshari, A. ., & Acharya, A. (2021). Drug utilisation pattern of antihistamines in upper respiratory tract infections in paediatric patients. Journal of Kathmandu Medical College, 10(1). Retrieved from https://jkmc.com.np/ojs3/index.php/journal/article/view/1074


Background: Upper respiratory tract infections (URTIs) are the most common infections in the paediatric population leading to health care consultations. Antihistamines are commonly prescribed medicines in children.

Objectives: This study attempted to assess the current prescription patterns of antihistamines used in the treatment of URTIs.

Methods: A descriptive cross-sectional study was conducted in the outpatient paediatric department of Kathmandu Medical College from January 2020 to April 2021. Ethical approval was taken from Institutional Review Committee of Kathmandu Medical College. A convenient sampling technique was used. The data were collected from the outpatient department prescription card into a suitably designed proforma. Drug use indicator developed by the World Health Organisation for Rational Use of Drugs was utilised. Data were analysed using SPSS v.20.

Results: Data from prescriptions of 345 patients aged less than 14 years were collected from the paediatric outpatient department of KMCTH. The most common condition was common cold (132, 38.26%). Most commonly prescribed antihistamines were Fexofenadine (156, 45.21%). Average number of drugs per prescription was 2.31. The total number of drugs prescribed by generic name was 128 (16%). Antibiotics made its place in prescriptions 279 (34.96%) times. No parenteral medication was used and 140 (17.5 %) of all drugs prescribed were from the National List of Essential Medicines.

Conclusion: Antihistamines, mostly second generation, were commonly prescribed in URTIs in paediatric patients. Majority of WHO indicators were within normal limits while some needed marked improvement. Different programmes can be implemented for improvement in prescribing patterns and promotion of rational drug use.



Lunde PKM. The World Health Organisation essential drug concept three years afterwards. In: Turner P, Padgham C, Hedges A, editors. Clinical Pharmacology & Therapeutics. London: Springer; 1980 (pp. 529-35). [Full Text | DOI]

Joseph N, Bharathi DR, Sreenivasa B, Nataraj GR, George N, Safdar M. Prescribing pattern of drugs in upper respiratory tract infections in pediatric outpatients. Int J Contemp Pediatr. 2016 Jul;3(3):1006-08. [Full Text | DOI]

Pise HN, Padwal SL, Jadhav RR, Deshmukh VS, Jadhav AD, Kolhe AM. Drug prescribing and dispensing pattern in pediatrics outpatient clinic of a rural tertiary-care teaching hospital. Natl J Physiol Pharm Pharmacol. 2015;5(4):313-7. [Full Text | DOI]

Lamichhane DC, Giri BR, Pathak OK, Panta OB, Shankar PR. Morbidity profile and prescribing patterns among outpatients in a teaching hospital in Western Nepal. McGill J Med. 2006 Jul;9(2):126-33. [PubMed | Full Text]

Nandimath MK, Ahuja S. Drug prescribing pattern in upper respiratory tract infection in children aged 1-14 years. Int J Pharm Bio Sci. 2012;3(1):299-308. [Full Text]

Helms PJ, Ekins Daukes S, Taylor MW, Simpson CR, McLay JS. Utility of routinely acquired primary care data for paediatric disease epidemiology and pharmacoepidemiology. Br J Clin Pharmacol. 2005 Jun;59(6):684-90. [PubMed | Full Text | DOI]

Brown RE, Stevens DR, Haas HL. The physiology of brain histamine. Prog Neurobiol. 2001 Apr;63(6):637- 72. [PubMed | Full Text | DOI]

Ten Eick AP, Blumer JL, Reed MD. Safety of antihistamines in children. Drug Saf. 2001;24(2):119- 47. [PubMed | Full Text | DOI]

Sisay M, Mengistu G, Molla B, Amare F, Gabriel T. Evaluation of rational drug use based on World Health Organization core drug use indicators in selected public hospitals of eastern Ethiopia: A cross sectional study. BMC Health Serv Res. 2017 Feb 23;17(1):161. [PubMed | Full Text | DOI]

National list of essential medicines Nepal [Internet]. 2016. [Full Text]

Tiwari P, Ahlawat R, Gupta G. Prescription practice in patients of upper respiratory tract infection at a paediatric outpatient clinic in Punjab. Indian J Pharm Pract. 2014 Apr-Jun;7(2):26-32. [Full Text | DOI]

Zeru T, Berihu H, Buruh G, Gebrehiwot H. Magnitude and factors associated with upper respiratory tract infection among under-five children in public health institutions of Aksum town, Tigray, northern Ethiopia: An institutional based cross-sectional study. Pan Afr Med J. 2020 Aug 19;36:307. [PubMed | Full Text | DOI]

Tiwari P, Ahlawat R, Gupta G. Pattern of prescribing at a paediatric outpatient setting in northern India. Indian J Pharm Pract. 2012;5(1):40-4. [Full Text]

Kolasani BP, Divyashanthi CM, Sasidharan P, Kothandapany SV. Prescription analysis of both H1 and H2 antihistamines among in-patients of dermatology department of a tertiary care teaching hospital in a coastal town of south India. Natl J Physiol Pharm Pharmacol 2016;6(6):537-43. [Full Text]

González MA, Estes KS. Pharmacokinetic overview of oral second-generation H1 antihistamines. Int J Clin Pharmacol Ther. 1998 May;36(5):292-300. [PubMed | Full Text]

Popov TA, Dumitrascu D, Bachvarova A, Bocsan C, Dimitrov V, Church MK. A comparison of levocetirizine and desloratadine in the histamineinduced wheal and flare response in human skin in vivo. Inflamm Res. 2006 Jun;55(6):241-4. [PubMed | Full Text | DOI]

Das B, Sarkar C, Majumder AG. Medication use for paediatric upper respiratory tract infections. Fundam Clin Pharmacol. 2006 Aug;20(4):385-90. [PubMed | Full Text | DOI]

Mirza NY, Desai S, Ganguly B. Prescribing pattern in a pediatric out-patient department in Gujarat. Bangladesh J Pharmacol. 2008 Aug;4(1):39-42. [Full Text | DOI]

Roy V, Rana P. Prescribing generics: All in a name. Indian J Med Res 2018 May;147:442-4. [PubMed | Full Text | DOI]

Senok AC, Ismaeel AY, Al-Qashar FA, Agab WA. Pattern of upper respiratory tract infections and physicians’ antibiotic prescribing practices in Bahrain. Med Princ Pract. 2009;18(3):170-4. [Full Text | DOI]

Karande S, Sankhe P, Kulkarni M. Patterns of prescription and drug dispensing. Indian J Pediatr. 2005 Feb;72 (2):117-21. [PubMed | Full Text | DOI]

Mittal N, Mittal R, Singh I, Shafiq N, Malhotra S. Drug utilisation study in a tertiary care center: Recommendations for improving hospital drug dispensing policies. Indian J Pharm Sci. 2014 Jul;76(4):308-14. [PubMed | Full Text]

Tamuno I, Fadare JO. Drug prescription pattern in a Nigerian tertiary hospital. Trop J Pharmaceut Res. 2012;11(1):146-52. [Full Text | DOI]