Drug Utilization Evaluation in COVID- 19 Hospitalized Patients: A Retrospective Study

Abstract

Introduction: Corona disease 2019 (COVID-19) is an airborne viral infectious disease caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) mutant. Transmission can occur if splashed or sprayed with contaminated fluids in the eyes, nose, or mouth, and, rarely, via contaminated surfaces. Symptoms are slightly variable with the mutants, and the general is fever, cough, headache, fatigue, breathing difficulties, and loss of smell and taste. The co-morbid diseases like cancer, cardiovascular disease, diabetes, hypertension, and chronic respiratory disease & the elderly are more likely to develop severe illnesses. The standard diagnostic method and treatment pattern varies from hospital to hospital, provokes to carry out this project. 
 Objectives: To assess the drug treatment pattern, antibiotic usage patterns, and cost, determine the antiviral usage pattern and its price. Estimate anti–interleukin-6 receptor monoclonal antibody (Tocilizumab) usage and cost.
 Methodology: A retrospective observational study was conducted in Sagar Hospitals, Kumaraswamy Layout, Bangalore, for six months after obtaining ethical clearance using a well-designed questionnaire.
 Results and Discussion: 155 Cases were collected from the medical records department. The most widely used antibiotic was Ceftriaxone, 60.6%, a cell wall synthesis inhibitor, followed by Azithromycin, 59.4%, a protein synthesis inhibitor. The most widely used antiviral was Oseltamivir in 51.6%, Remdesivir in 41.3% of patients, and Favipiravir in 12.3%. Other co-morbid drugs are corticosteroids, immunomodulators, mucolytics, antihistamines, blood thinners, and anti-helminthes. The mean cost of the antibiotics and antiviral are 224 ± 295.73; 1623.28 ± 2047.45.
 Conclusion: This study showed that in the management of COVID 19, ICMR Guidelines were adopted. The cost of the drugs also played a significant role in selecting treatment regimens, especially antibiotics, antiviral, and immunomodulators. Hence the cost consideration studies may help in Rational drug usage promotion and cost-minimization in disease management.