Evaluation of prescribing patterns using WHO core drug use indicators in a pediatric hospital of Kabul Afghanistan: A prospective cross-sectional study

BACKGROUND: The global issue of irrational drug use, particularly concerning pediatric patients, is a significant concern. Notably, there has been a lack of studies assessing rational drug prescribing for pediatric patients within Afghanistan's healthcare system. This investigation aimed to address this gap by examining drug prescribing patterns at the Indira Gandhi Pediatric Health Institute (IPHI) in Kabul, Afghanistan. METHODS: A prospective cross-sectional analysis was conducted to evaluate the prevailing drug prescribing practices at the outpatient department of IPHI in Kabul, Afghanistan. A systematic random sampling method was employed to select 600 outpatient prescriptions from the institute, following the World Health Organization (WHO) guidelines for investigating drug utilization in healthcare facilities. RESULTS: The average age of patients was 4 years, and the average number of drugs per prescription was 2.9. Notably, 84% of prescriptions included one or more antibiotics, surpassing the WHO standard of <30%. Furthermore, 67% of the prescribed drugs were listed on Afghanistan's national essential drugs list (EDL), falling below the standard value of 100%. Only 35.1% of the prescribed drugs were in generic form, also lower than the recommended 100%. Moreover, 5.7% of all prescriptions included injections, the ideal value is <20%. The most frequently prescribed drug groups were anti-microbials (25.7%), followed by non-steroidal anti-inflammatory drugs (NSAIDs), (21.4%), gastrointestinal drugs (17.3%), and vitamins (7.8%). CONCLUSION: The study's findings indicate that, on average, a higher number of drugs were prescribed per patient visit at IPHI compared to recommended standards. Additionally, there was a lower utilization of generic drugs and drugs from Afghanistan's national essential drugs list (EDL), with an over-prescription of antibiotics.