Evaluation of Drugs Used in Postoperative Care Following Different Paediatric Ocular Surgeries in a Tertiary Care Hospital: Pattern, Safety and Cost-Effectiveness.

Abstract

Background: Postoperative pharmacotherapy in children undergoing ocular surgery requires careful consideration because of age-related differences in drug response, safety, adherence, and cost. Evidence regarding prescribing patterns and safety of postoperative ocular medications in paediatric patients, particularly in Eastern India, remains limited.

Objectives: To evaluate the drug utilization pattern, safety profile, and cost-related aspects of postoperative medications prescribed to paediatric patients undergoing ocular surgeries in a tertiary care hospital.

Methods: A cross-sectional, observational study was conducted over six months at the Regional Institute of Ophthalmology, Medical College and Hospital, Kolkata. Paediatric patients aged below 12 years receiving postoperative medications following ocular surgery were enrolled. Data regarding diagnosis, surgery, prescribed drugs, generic prescribing, drug availability, adverse drug reactions (ADRs), and treatment cost were collected using a predesigned case record form. WHO prescribing indicators and CDSCO ADR reporting criteria were used for assessment. Descriptive statistics were applied.

Results: Eighty-one patients were evaluated, with cataract being the commonest diagnosis (71.6%). Tobramycin was the most frequently prescribed antibiotic (85.2%). Prednisolone acetate was the most commonly prescribed corticosteroid. Polypharmacy was frequent, with seven drugs prescribed in most patients. Generic prescribing was observed in 84.1% of patients receiving tobramycin. ADRs included ocular irritation, blurred vision, diarrhoea, gastric irritation, and photophobia. A substantial proportion required purchase of medicines from outside the hospital supply.

Conclusion: Postoperative paediatric ocular care demonstrated frequent polypharmacy, substantial use of topical antibiotics and corticosteroids, and some treatment-related out-of-pocket expenditure. Rational prescribing, ADR monitoring, and cost-conscious selection of medicines may improve the safety and affordability of postoperative paediatric ocular care.