Pattern of drug utilization in acute tonsillitis in a teaching hospital in Nepal

  • H. S. Rehan
Main Article



A prospective study was undertaken to find out the baseline data on prescribing patten of drugs in acute tonsillitis.


Prescriptions far acute tonsillitis were collected outside the ENT-OPD over a period of 6 months and were analyzed.


The average number of drugs per prescription was 3.24. Ninety five percent of the prescriptions contained antimicrobial agents (AMA with an average of 1.03 AMAs per prescription. AMA was the most commonly prescribed (31.81%) group of drugs followed by analgesics and antipyretics (20.70%). Amoxicillin (38.80%) and azithromycin (20.63%) were the most commonly prescribed AMAs. Erythromyein was prescribed in 11(6.73) patients while penicillin was not at all prescribed. Culture and sensitivity test was advised only in 14.75% of cases. Cough expectorants were the most commonly used fixed dose combination. Of the total drugs used, 96.9% were prescribed by brand names. The duration of therapy was not mentioned for 35.60% of the drugs prescribed. the iatyprtyriate and over use off antimicrobil agents make treatment east effective.

Key Words

Drug Utilization Antimicrobial use Acute Tonsillitis 


  1. 1.
    Anonymous (1989): Reserve antibiotics, WHO drug Information, 3: 163–6.Google Scholar
  2. 2.
    Anonymous (1991): Health Department Victoria. Antibiotic Guidelines. 6th Edition Melbourne: Victorian Postgraduate Medical foundation.Google Scholar
  3. 3.
    Anonymous (1996): Acute Respiratory infection. Health and Nutrition phase-I. Nepal Multiple Indicator Surveillance, HMG Nepal – UNICEF collaboration, Kathmandu, Nepal, pp. 49 - 50.Google Scholar
  4. 4.
    Aronoff S. C., Klinger J. D., O’brien C. A., Jaffe A. C, Blummer J. L. (1984): A double blind study of sultamicillin and potassium penicillin V in the treatment of childhood streptococcal pharyngitis. J. Antimicrob. Chemo. 14: 261–5.CrossRefGoogle Scholar
  5. 5.
    Breese B. B. Disney F. A., Talpey W., Green J. L. Tobin J. (1974): Streptococcal infections in children Am J. Dis. Child. 128: 457–60.PubMedGoogle Scholar
  6. 6.
    Coleman B. H. (1995): Hall & Coleman’s Disease of the Nose, Throat and Ear and Head and Neck. Churchill Livingstone, Oxford University Press, pp. 97’98.Google Scholar
  7. 7.
    Dunea G. (1977): Shopping bag syndrome. Br. Med. J 2: 240–1.PubMedCrossRefGoogle Scholar
  8. 8.
    Feigin R. D. & Cherry M. D. (1987): Text Book of Pediatric Infectious Diseases. WB Saunder Co. Philadelphia, pp. 1305–16.Google Scholar
  9. 9.
    Gau D. W., Horn R. F. H., Solomon R. M., Johnson P., Leigh D. A. (1972): Streptococcal tonsillitis in general practice: A comparison of cephalexin and penicillin therapy. 208: 276–81.Google Scholar
  10. 10.
    Gerber M. A., Spadaccini L. J., Wright L. L., Deutsch L., and Kaplan E. L. (1985): Twice daily penicillin in the treatment of streptococcal pharyngitis. Am. J. Dis. Child. 139: 1145–48.PubMedGoogle Scholar
  11. 11.
    Kafle K. K. and Khannal (1995): Prescribing practice at private sector in Nepal. J. Inst. Med. 17: 147–8.Google Scholar
  12. 12.
    Kunin C. M., Tupasi T., Crainge W. A. (1973): Use of antibiotics a brief exposition of the problem and some tentative solution. Ann. Int. Med. 79: 555–60.PubMedGoogle Scholar
  13. 13.
    Laporte J. R. (1985): Towards a healthy use of Pharmaceuticals. Development Dialogue 2: 48–55.PubMedGoogle Scholar
  14. 14.
    Melrose D. (1987): Bitter pills: medicines and the third world poor. Oxford OXFAM.Google Scholar
  15. 15.
    MacDougall G., and Denoholm S. W. (1995): Audit of treatment of tonsillar and peritonsillar sepsis in an Ear, Nose & Throat unit. J. Laryng. Otology. 109: 531–3.Google Scholar
  16. 16.
    Perez C. R., Munoz O., Gutierrez G. (1992): Patrones de prescription terapeutica in infection respiratoria ageuda Y diarrea aguda en dos instituciones de salud (IMSS, SSA); IV: characteristicas de la prescripcion medica. Gac. Med. Mex. 128: pp. 531.Google Scholar
  17. 17.
    Ricard P. C, Hector G., Onofre M., Hortensia R., Patricia T., Vita L., Gonzalo G. (1996): Improving physician prescribing patterns to treat Rhinopharyngitis intervention strategies in two health system of Mexico. Soc. Sci. Med. 42 (8): 1185–94.CrossRefGoogle Scholar
  18. 18.
    Soumnerai S. B. and Ross -Degman D. (1990): Drug prescribing in pediatrics: challenges for quality improvement. Pediatrics, 86: pp.782.Google Scholar
  19. 19.
    Uppal R., Sarkar U., Giriappanayar C. R., and Kochar V. (1993): Antimicrobial drug use in primary health care. J. Clin. Epidemiol. 46: 671–3.PubMedCrossRefGoogle Scholar
  20. 20.
    World Health Organization (1989): Case management of acute respiratory infection in children for developing countries. Manual for doctors and other Senior Health Workers. Acute Respiratory infections control program.Google Scholar
  21. 21.
    Zwar N. A., Gordon J. J. and Fisher S. (1994): Antibiotic and benzodiazepine prescribing by general practitioner trainees. Med. J. Aust. 161: 491–3.PubMedGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2001

Authors and Affiliations

  • H. S. Rehan
    • 1
  1. 1.Department of PharmacologyLady Hardinge Medical College & HSMT, S. K. HospitalNew Delhi

Personalised recommendations