Drug Utilization Review of Antiepileptic Medications in Pediatric Patients: Insights from a Rural Secondary Care Hospital

Abstract

Introduction: Seizure is  one of the most common neurological disorders in pediatric populations, often requiring management with antiepileptic drugs (AEDs). Drug utilization studies play a crucial role in evaluating prescribing patterns, optimizing therapy, and improving clinical outcomes. This study aims to assess AED utilization in pediatric patients at a rural secondary care hospital, providing insights into current treatment effectiveness and safety.

Aim: The study aims to evaluate the prescribing patterns of AEDs in pediatric patients and analyze the safety and efficacy of various AED regimens in a rural healthcare setting.

Study Design: A prospective, observational study involving pediatric inpatients at a rural secondary care hospital was conducted over a six-month period, from December 2023 to May 2024.

Methodology: The study includes 120 pediatric patients aged 1–14 who are prescribed AEDs. Data are collected on demographics, seizure types, AED regimens (monotherapy, dual therapy, polytherapy), and adverse drug reactions (ADRs). The causality of ADRs is assessed using the Naranjo Causality Assessment Scale. Statistical analysis is performed using SPSS V.17 to identify patterns and associations between seizure types, drug utilization, and clinical outcomes.

Results: The results show that 51% of the patients are aged 1–5 years, with tonic-clonic seizures being the most common type (23.3%). Clobazam is the most frequently prescribed AED (49%), followed by sodium valproate (34%) and midazolam (36%). Monotherapy is administered to 32% of the patients, dual therapy to 54%, and polytherapy to 8%. A seizure-free rate of 87% is observed, while 10% of patients report 1–2 episodes, and 3% experience more than two episodes. ADRs, primarily associated with phenytoin, include ataxia, rashes, and lymphadenopathy, leading to drug discontinuation in some cases.

Conclusion: This study highlights the prevalent use of Clobazam and the efficacy of dual therapy in managing pediatric seizures. The findings underscore the importance of continuous monitoring for ADRs, particularly in patients receiving phenytoin, and the role of clinical pharmacists in optimizing therapy. The high seizure-free rate suggests that AED regimens, when tailored to seizure type, can significantly improve outcomes in pediatric populations, particularly in rural healthcare settings.