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Aim: The study was conducted to assess the prescribing behaviour for antimicrobials and various groups of drugs in tertiary care hospital in Puducherry. Prescription audit was done. Total 500 presc Method: riptions were analysed for sex wise distribution, no of patients for specific age group, antimicrobials prescribed in generic name, percentage of antibiotics, antacids, NSAIDs and multivitamins, among the prescribed drugs, groups of antibiotics, drugs prescribed from National List of Essential Medicines (2022), use of fixed drug combinations, injectable preparations if any. Results: Demographic analysis showed that out of 500 patients in OPD, most were female (53%) and in the age group between 41 to 60 years. In 500 number of prescriptions,9.96% of antibiotics were prescribed; fluoroquinolones (5.42%) were prescribed more from antibiotics followed by extended spectrum penicillin (1.64%).14.78%of antacids were prescribed; PPIs (11.28%) were prescribed more from antacids.21.63% of NSAIDs were prescribed.11.66% were prescribed in generic names,65.44% drugs were prescribed from National List of Essential Medicines (2022),15.88% of FDCs were prescribed,6.13% of injectable preparations were prescribed. The rational use of antimicrobial agents is one of the main contribut Conclusion: ors to control worldwide emergence of bacterial resistance, side effects and reduced cost of the treatment.
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Background : 20-30% of the Indian population suffers from at least one allergic disease that can have an adverse impact on the quality of life of the patients. Aim : To develop expert opinion-related guidance for the diagnosis and management of allergic disorders. Methodology : An advisory board meeting (hybrid mode) was conducted with 11panel members of the Indian Medical Association (IMA). The panel members discussed issues related to the management of allergic disorders based on the Delphi method. Result : Spirometry is helpful in selected patients of allergic rhinitis where the coexistence of asthma is suspected. In patients with urticaria second-generation antihistamines are preferred for both adults and children due to their low side effects, less drug-drug interaction, anticholinergic effects, longer duration of action, and higher safety. Diagnosis of allergic contact dermatitis can be made based on occupational and exposure history. In atopic dermatitis, patient education about lifestyle changes can prevent flare-ups. In patients with asthma, patients must be educated about the use of the peak flow meter. The diagnosis of food allergy can be made by correlating the food intake timing withthe patient history and the results of allergy testing. Allergic drug reactions can be treated with oral antihistaminic drugs, emollients, and if needed topical corticosteroids. Conclusion : The diagnosis of allergic disorders requires the clinician to consider the clinical presentation, patient history, presence of triggers, and comorbid conditions. Patient education and the new generation of antihistaminic drugs can improve the quality of life of patients with allergic disorders
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Dry eye syndrome (DES) is a common disorder with rising incidence due to increased use of digital devices. While multiple treatment options are available, some are not efficacious or sometimes even safe for use in DES. This is particularly true for Fixed Dose Combinations (FDCs) that may contain ingredients having no rational for their use or may actually be harmful. Various committees appointed by the Government have reviewed several FDCs marketed in India and found some of them to be irrational and recommended for their removal. This paper discusses the contents of some of these FDCs marketed for DES with an aim to ensure that prescribers are mindful of their ingredients and whether there is adequate data about their efficacy and safety and prescribe them only if they consider them necessary for managing the patient.
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Background: Evaluation of the pattern of fixed dose combinations (FDCs) prescribing among the practitioners in India. Aims and Objectives: Aims and objectives of the study was to find out prevalence, prescribing pattern and rationality of FDCs in Jhalawar district of Rajasthan. Materials and Methods: Photocopies of one thousand prescriptions of general practitioners, containing 800 FDCs were randomly collected from few big pharmacies of Jhalawar district of Rajasthan and analyzed for the different pattern of prescribing and rationalism. Results were expressed as percentages. After excluding the repetitions, the numbers of FDCs were 218, which were considered for final analysis. Results: Out of 218 FDCs, the most commonly prescribed FDCs were of anti-microbial agents followed by anti-inflammatory drugs and anti-hypertensive drugs. The FDCs were maximum from the department of medicine (30.2%), followed by surgery (20.2%) and Obstetrics (16.9%). Out of 218 FDCs, only 13.3% were rational, and rest of the FDCs was irrational. 94% of all FDCs prescribed with brand names. Conclusions: In our study, most of the prescriptions contains irrational FDCs. Physicians have no knowledge about the essential drugs and FDCs. Therefore, physicians and regulators should be educated regularly by seminars and conferences. Government laws should be made mandatory. Implementation of central drug standard control organizations guidelines on industries for manufacture of FDCs must be made compulsory.
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Background: The global incidence and prevalence of analgesic nephropathy is 28% in 1981 and 12% in 1990. Intake of 6–8 tablets per day for 6–8 years attributes to development of analgesic nephropathy. This article serves caution and reminder about unnoticed renal threat posed by long-term use of analgesics. Aim and Objectives: The study objective is to assess the drug utilization pattern in patients of analgesic nephropathy. Materials and Methods: It is a cross-sectional observational study, carried out across multicenter under the tertiary care hospital, after obtaining permission from respective institutes. Data were collected on demographic features such as age, gender, duration, and type of analgesics used by patients from various monitoring centers through CDSCO forms. To analyze the drug utilization pattern, the World Health Organization prescribing indicator scales were applied. Results: A total of 32 patient case sheets were analyzed, showing more of females (65.6%) being affected compared to men. Involving more patients aged above 31–50 years (50%). 51–70 years (37.5%) being affected with cyclooxygenase (COX-2) inhibitors along with nonselective COX inhibitors. The most common prescribed are COX-2 inhibitors such as Diclofenac and Aceclofenac along with combination of Paracetamol. 40.4% patients were affected with fixed drug combinations and usage of drugs between 2 and 6 months were 34.4%. 56% landed with acute renal failure and 44% were progressed to end stage renal disease. Conclusions: Usage and prescribing of analgesics were more of irrational combinations and patients taking self-medication for long duration were against the WHO standards.
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Objective:Aim of this study is to assess the drug utilization pattern of cardiovascular drugs in cardiology outpatient department (OPD). Methodology:This prospective, multicenter, cross-sectional observational study was conducted at three selected tertiary care hospitals from different regions in South India. A total of 1026 prescriptions of the patients attending cardiology OPD of these selected hospitals 342 each over a period of 12 months was randomly identified and included in this study then critically analysed for WHO/INRUD core prescribing indicators. Results:Medicines prescribed from NLEM were 89.27%, average drugs prescribed was 5, medicinesprescribed by its generic name were 2.33% and encounters with an injection prescribed were 14.52%. Commonly prescribed different class of drugs for CVDs patients were Anti-platelets (67.73%) followed by Statins (62.57%), Beta blockers (49.51%), ACE-inhibitors (40.93%), Angiotensin receptor blockers (30.40%), Calcium channel blockers (30.11%), Nitrates (25.34%), Diuretics (20.56%), Anticoagulants (20.27%), Vasodilators (9.94%) rest of the cardiovascular drugs were prescribed within 0.5-5% only, other class of drugs also prescribed for patients with different comorbidities are Anti-ulcers (69.10%), Opioid analgesics (4.09%), Antacids (3.80%), Anti-emetics and Pro-kinetics (1.85%), a pattern of poly-pharmacy was clearly evident, majority of drugs were prescribed as single drug (86.78%) whereas 13.21% as FDCs. The most commonly prescribed single drug was Aspirin (59.93%) and FDCs were Aspirin + Clopidogrel (40.24%). Anti-thrombotic agents’ particularly antiplatelet drugs expected to overtake anti-cholesterol drugs as the sales leader in the market. Maximum drugs were prescribed from the recent NLEM of India by most of practitioners its shows its acceptance and implementation by the prescribers.Conclusion: Deprescribing PPIs for the non-required patients is suggested to lower the risk of adverse drug interactions and economic burden to patients, also pharmacists needs to encourage the prescriptions with drugs in generic name if it’s deviated from the standards recommended by WHO/INRUD
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Background: Study of prescription patterns is an important to determine rationality of drug therapy and to maximize the utilization of resources. Objective: This prospective, multicenter, cross-sectional observational study was conducted at three selected tertiary care hospitals in South India to assess the drug utilization pattern (DUP) of cardiovascular drugs in outpatient department (OPD). Materials and Methods: A total of 1026 prescriptions of the patients attending cardiology OPD over a period of 1 year were randomly identified then critically analyzed for World Health Organization (WHO) core prescribing indicators. Results: The average number of drugs prescribed was five and medicines prescribed by its generic name were 2.33%, encounters with an injection prescribed (14.52%), medicines prescribed from National List of Essential Medicine (NLEM) were 89.27%, apart from above some other class of drugs also prescribed for patients with different comorbidities. Majority of drugs were prescribed as single drugs (86.78%) whereas 13.21% as fixed-dose combinations (FDCs). The most commonly prescribed single drug was aspirin (59.93%) and FDC were Aspirin + Clopidogrel (40.24%). Most of drugs were prescribed from the recent NLEM of India which indicates the implementation and adoption of national drug policy by the hospitals and cardiologists. Conclusion: Antiplatelets dominated the prescribing pattern in the cardiology OPD and expected to overtake anti-cholesterol agents as the sales leader. Updated knowledge about the banned drugs, irrational FDCs, deleted drugs, and recent NLEM are very important to both practitioners and pharmacists, also pharmacists have to encourage the prescribers to prescribe the cardiovascular drugs by its generic name.
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Background: Fixed dose combination (FDC’s) of ?1-blockers and 5?-reductase inhibitors have commonly been used in patients with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). This study compared the effect of FDC’s of tamsulosin, alfuzosin and silodosin with dutasteride on quality of life (QoL) in patients of LUTS with BPH.Methods: Ninety-six male patients aged ?45 years diagnosed with LUTS and BPH were randomized to receive FDC’s of dutasteride with tamsulosin (group 1), alfuzosin (group 2) and silodosin (group 3) over a period of 16 weeks. Quality of life was assessed using International Prostate Symptom Score (IPSS) 8th question, BPH impact index (BII) and modified Patient Perception of Study Medication (PPSM) questionnaire.Results: IPSS 8th question score improved significantly by 61.68%, 57.63% and 63.4% in group 1, 2 and 3 respectively. BPH Impact Index score also improved significantly by 62.95%, 60.13% and 61.82% in group 1, 2 and 3 respectively. All the three treatments were found to be similar in improving the QoL. Majority of patients were satisfied with their treatment and wanted to receive the medication again while a small number of patients were neutral with the study medication. None of the subjects was dissatisfied with any of the treatment.Conclusions: All the FDC’s improved QoL and were found to be satisfactory as per patient perception of study medications.
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Background: Medicines are an integral part of healthcare. More than one drug is frequently used for treatment of either single ailment or multiple co-morbid conditions. Sometimes, two or more drugs are combined in a fixed ratio into a single dosage form, which is termed as fixed dose combinations (FDCs).Methods: This prospective observational study was carried out in the patients admitted in various medical and surgical wards of Chirayu hospital associated with Chirayu medical college of Bhopal district for a period of 3 months. The prescribed FDCs were collected from the case sheet of the admitted patients. Patients of all ages and both sexes were included in the study.Results: The total numbers of prescriptions from teaching hospital were 475, out of which 373 patients (78.52%) were prescribed FDCs. The first four most preferred FDCs were B complex preparations followed by pantoprazole + domperidone, Diclofenac+Paracetamol and Chlorpheniramine+Pseudo-ephedrine+Paracetamol.Conclusions: In present study total 11types of FDCs were prescribed, out of 11 FDCs prescribed; only 1 type was enlisted in the essential drug list of WHO and Govt. of India. In only 4 types of FDCs there is scientific justification for combining ingredients. Most of FDCs do not have scientific justification for combining the ingredients. It is the need of the time that hospitals should constitute drugs and therapeutics review committees to promote rational prescription of FDCs.
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Background: Fixed dose drug combinations (FDCs), are combinations of two or more active drugs. It should be used when the combination has an established advantage over single drug in efficacy, safety and compliance. The World Health Organization (WHO) lists only 19 of such combinations. But Indian market is filled with hundreds of FDCs which were not approved leading to irrational use. This study was focused on finding out the fixed dose combination of antimicrobial agents used in the post-operative general surgery ward of a tertiary care teaching hospital.Methods: After getting approval from institutional human ethics committee the prescriptions of patients admitted during April 2013 to March 2014 were analyzed. Demographic data, FDC prescribed by surgeons, Dose, Frequency, Duration, Route, Formulation, Brand or generic drugs, Adverse events due to use of FDC were collected and SPSS version 17 was used for statistical analysis. Fixed dose combinations were used in 90 Patients. The most commonly used FDC were ampicillin with Cloxacillin (43) followed by amoxicillin with clavulanic acid (22), cefoperazone with sulbactam (19) and piperacillin with tazobactam (6). A common drug used in combination along with FDC was metronidazole and aminoglycoside. The irrational combination seen in this study was ampicillin with Cloxacillin (8.88%) of the total FDC which is not approved by DCGI or FDA.Results: In this study out of 145 drugs used, 41drugs were administered three times a day, 90 drugs were given two times a day and 14 drugs were given once a day dosing. 53 patients received FDCs for prophylaxis and 37 patients for treatment purpose. All FDCs were prescribed in brand names. No adverse drug reaction was observed in this study.Conclusions: Consultants should undergo continuing medical education (CME) on newer drug combinations and their adverse drug reactions which will be evidence-based rather than to rely on representatives.
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This cross-sectional study was carried out to assess drug prescribing pattern at a tertiary care teaching medical institute. One thousand prescriptions were randomly collected and analyzed using the world health organization prescribing indicators. The average number of drugs per prescription was 2.91. The percentage of drugs prescribed by generic name, from the essential drug list (National) and as fixed dose combinations (FDCs) was 10.05%, 22.57%, and 49.22%, respectively. The total percentage of encounters with antibiotics, injectables, and FDCs was 19.70%, 2.20%, and 73.60%, respectively. The most common group of drug prescribed was gastrointestinal tract drugs (26.38%) followed by Vitamins and Minerals (23.12%), cardiovascular system drugs (11.56%) and antimicrobials (9.63%). The prescribing practices were not appropriate as they consist of polypharmacy, lesser prescription by generic name, and overprescription of FDCs. There is a need for improvement in the standards of prescribing patterns in many aspects.
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Background: The present study was designed to assess awareness regarding rational drug therapy and fixed dose combinations (FDC) amongst interns and II MBBS students in a tertiary-care teaching hospital in Maharashtra, India.Methods: This cross-sectional, questionnaire-based study containing MCQ and analytical questions on rational drug therapy, fixed dose combinations and role of Pharmacist in dispensing correct drug to the patients was carried out in both interns (n=80) and II MBBS students (n=100). The completed questionnaires were then collected and analysed statistically for responses.Results: Mean average score obtained by II MBBS students (score - 36.66marks) was significantly better than interns (score- 20marks) which probably may be due to pharmacology teaching they were undergoing. II MBBS students were found to be better informed as compared to the interns (p<0.05) on questions related to rational drug therapy. On the questions related to rationality of FDC in Yes/No type, interns and II MBBS students were found to be equally informed (p>0.05). However, on question related to justification of FDC, interns were found to be better informed as compared to the II MBBS students (p<0.05). On single question pertaining to role of pharmacist, interns were found to be better informed than II MBBS students possibly due to their better understanding of patient-pharmacist relationship.Conclusions: Our study highlights the significance regarding knowledge of rational drug therapy and fixed dose combination (both rational and irrational), both rational and irrational, amongst both interns and II MBBS students while identifying the possible areas of interventions to make them rational clinicians.
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Objective: To highlight the issue of freely available fixed‑dose combinations (FDCs) of antimicrobials. Methods: A critique of two such antimicrobial FDCs was undertaken wherein the following aspects were assessed ‑ rational and regulatory issues and justification for clinical use. Available in vitro, in vivo (animals and humans) evidence from published literature was analysed. Conclusions: There are several inadequately addressed aspects of the considered FDCs which are available in Indian market. In view of the growing problem of antimicrobial resistance, this issue must get the required attention.
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Abstracts: Background:Fixed Dose Combinations (FDCs) are combinations of two or more active drugs in a single form. Prescribing FDCs has become a routine affair in medical practice. Combination drugs increase the compliance of patient to the treatment, decrease the pill burden, but may also lead to increase in the cost of the treatment and side effects. There has been increase in the irrational FDCs in the recent past. The rationality of a fixed dose combination is the most controversial and debated issue in today’s clinical practice. The eighteenth essential medicine list (EML) of WHO includes 25 FDCs while as the 2011 national list of essential medicines (NLEM) of India includes only18 FDCs. Contrary to this Indian market is flooded with FDCs, the scientific rationale for most of these remains unknown. In India, a fixed dose combination of drugs is considered a “NEW DRUG” and has to be approved by Drugs Controller General, India (DCGI). However, the Indian laws governing the approval and marketing of FDCs are not properly defined, the pharmaceutical manufactures take advantage of these loopholes and market combination that have no pharmacological rationale.
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Background: There is a need to introduce clinical pharmacology at the undergraduate level in order to improve rational prescribing of medicines. The present study was undertaken to analyze drug utilization pattern of genitourinary infections to teach certain basic skills to MBBS students which will form an integral component of practicing rational therapeutics. Methods: The retrospective study was conducted by Pharmacology Department in Shri Guru Ram Rai Institute of Medical and Health Sciences (SGRRIM and HS). A total of 92 prescriptions were collected by second professional MBBS students and randomly evaluated for prescribing pattern using WHO drug indicators. Results: A total of 92 prescriptions were analyzed. Male:female ratio was 1.96:1. Age wise distribution was done: 0-15 years were 14 (15.21%), 16-30 years were 26 (28.26%), 31-45 years were 24 (26.08%), 46-60 years were 19 (20.65%), and >60 years were 9 (9.78%). A total of 260 drugs were prescribed. 116 (44.61%) antimicrobials, 70 (26.92%) antacids and antiemetics, 40 (15.38%) analgesics, 11 (4.23%) urinary alkalizers, 9 (3.23%) antifibrinolytics, and 14 (5.38%) miscellaneous drugs were prescribed. 144 (55.38%) injectable and 116 (44.61%) oral drugs were prescribed. Numbers of fi xed-dose combinations were 32 (34.78%). 2.82 drugs per prescription were prescribed. 171 (65.76%) drugs were prescribed from National List of Essential Medicines 2013 (NLEM 2013). Majority of drugs were prescribed by brand names. Conclusion: Majority of drugs were prescribed from NLEM 2013. The main purpose of undergraduate medical curriculum is to develop the requisite diagnostic and therapeutic skills of a basic doctor. It is only by drug utilization studies that burden of diseases and corresponding utilization of drugs can be measured.
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Aims: To evaluate therapeutic rationality of combining long-acting β2-agonists (formoterol) with duration of action of 12 hours and anticholinergics (tiotropium) with 24 hours as fixed dose inhaled combination (FDC) still widely prescribed in developing countries in COPD patients. Study Design: A randomized, double-blind, placebo-controlled, parallel design study. The three regimens that were used; tiotropium 18 μg once a day in the morning along with the formoterol matched placebo in the evening, the FDC of tiotropium 18 μg plus formoterol 12 μg once a day in the morning and formoterol matched placebo in the evening and the same FDC of the two drugs once a day in the morning and once a day formoterol 12 μg in the evening in patients of COPD without any co-morbidity. Place and Duration of Study: Tertiary care pulmonary medicine university teaching government hospital of Delhi, India; 1 year. Methodology: Sixty COPD patients (Male, Avg. age 56±11 years) divided into 3 groups of 20 each without any comorbidity were admitted in the hospital for 24 hours. The spirometry, perception of dyspnea on Borg's scale and vitals such as blood pressure (BP) and pulse rate (PR) were recorded at the following interval 30 minutes, 2 hours, 12 hours after the morning dose and 30 minutes and 12 hours after the evening dose. Results: Addition of formoterol in the evening along with the FDC in the morning enhanced the peak effects in percentage predicted FEV1 (82.55+/-12.639), FEV1/FVC (0.592±0.097) that remained till the next dose (24 hours) which was statistically (P=.05) superior to the tiotropium alone group (75.55+/-17.981) as well as FDC alone group (74.55+/-12.655). Conclusion: There is no advantage of FDC once a day over tiotropium alone. However addition of evening dose of formoterol has shown therapeutic superiority over once a day FDC of the two in COPD.
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Background: The study was conducted to compare the current prescribing trends of Non-Steroidal Anti-inflammatory drugs (NSAIDS) among private practitioners and practitioners at tertiary care teaching rural hospital. Methods: The prospective survey study was carried out by obtaining response to feedback questionnaire related to use of NSAIDs from 25 private & 25 tertiary care practitioners. Results: NSAIDs use was routine amongst private (66%) and tertiary care (77.6%) practitioners. Preferences of tertiary care practitioners were paracetamol (36%), diclofenac (20%), aceclofenac (20%), ibuprofen (20%) and etoricoxib (4%) while that of private practitioners were ibuprofen (40%), paracetamol (32%), diclofenac (16%) and aceclofenac (12%). Use of Fixed Dose Combinations (FDC) was 72% in private and 68% in tertiary care practitioners. While prescribing FDCs, private practitioners preferred NSAIDs + NSAIDs (100%) over NSAIDs + muscle relaxants (44.44%), NSAIDs + Serratiopeptidase (55.56%), and NSAIDs + antacids (44.44%) similarly tertiary care practitioners also preferred NSAIDs + NSAIDs (100%) over NSAIDs + muscle relaxants (47.06%), NSAIDs + Serratiopeptidase (36%), and NSAIDs + antacids (28%). Of the NSAIDs + NSAIDs combination ibuprofen + paracetamol (70%) was preferred by private practitioners and diclofenac + paracetamol (61%) by tertiary practitioners. Paracetamol was safely used during pregnancy by both groups. Adverse effects observed included gastritis (98%), urticaria (32%), and anaphylaxis (2%), although no fatality was observed. Conclusion: Not much of a difference was observed in prescribing habits of both groups. Though beneficial and routinely prescribed, NSAIDs with equal risk potential were observed to be cautiously used with appropriate knowledge amongst both the groups.
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Background: Fixed dose combinations (FDCs) refer to products containing two or more ingredients used for a particular indication in a single dosage form. Prescribing FDCs has become a routine affair in medical practice. There has been increase in the irrational FDCs in the recent past by leaps and bounds. The pharmaceutical companies are luring the physicians to prescribe their products even when they are not needed by the patients. The Indian laws too are not properly defined to grant marketing approvals of FDCs. Hence the rationality of a FDC has become one of the most controversial and debatable issues in general practice. Methods: We hence decided to analyze the existing FDCs in Indian market and study their rationality. Results: We observed that, although many brands of FDCs available are essentially rational as per WHO and Indian essential drugs lists, the irrational FDCs easily outnumber the rational ones. Hundreds of rational FDCs are also available which are not included in WHO or Indian essential drugs lists. A few FDCs with incorrect doses were also noted. Irrational FDCs not only cause more adverse drug reactions but the antibiotic FDCs are responsible for increasing the chances of resistance. A few of these are discussed for their irrationality. Conclusions: It is the need of the hour to raise our voice against the growing list of irrational FDCs and try to reduce the magnitude of this problem by sensitizing the undergraduates, the interns as well as the practitioners regarding their efficacy, safety, suitability, rationality and cost benefit.
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The present study was undertaken to compare the efficacy and safety of timolol with dorzolamide, brimonidine or latanoprost in patients of primary open angle glaucoma. This prospective, observational study was conducted over one and a half year at the Regional Eye Institute, in patients of primary open angle glaucoma who were prescribed dorzolamide (2%) and timolol (0.5%) (DT), brimonidine (0.1%) and timolol (0.5%) (BT) or latanoprost (0.005%) and timolol (0.5%) (LT). Measurement of intraocular pressure (IOP) and indirect ophthalmoscopy was done at baseline and after 1, 3 and 6 months of treatment. Efficacy was assessed by the degree of reduction in intraocular pressure and change in cup-disc ratio. Adverse drug reactions (ADRs), if any, were recorded. The data was analysed using Student’s ‘t’ test and one-way ANOVA test. P value < 0.05 was considered to be statistically significant. Total number of 35 patients in DT group, 34 in BT group and 32 in LT group completed the study. At the end of 6 months, average reduction in IOP levels was 7.83, 9.39 and 9.73mmHg in DT, BT and LT groups respectively. Thus, a percent reduction of 29.4, 35.6 and 36.2 from baseline was observed in these groups respectively. While the reduction was maximum in LT group, there was no statistically significant difference between any of the groups at 1, 3 or 6 months. A total of 47 ADRs were reported, none of which required discontinuation. All three combinations are effective in reducing the IOP level in patients of primary open angle glaucoma and none appear to be superior to the others.
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Background: Irrational prescribing of drugs is of common occurrence in clinical practice. Rational drug prescribing is defined as “the use of the least number of drugs to obtain the best possible effects in the shortest period and at a reasonable cost”. The present study was designed to evaluate the practice of rational prescription in patients (cases) admitted in various wards of G.S.V.M. Medical College and associated hospitals at Kanpur. Methods: This study was carried out on patients admitted in different wards. For the study of drug prescribing patterns, each prescribed drug was counted only once for a patient, irrespective of change in dose and route of administration. WHO guidelines were taken into consideration. Both distribution of type of drug as well as drug category were evaluated in different departments thereafter. The characteristics chosen on each prescription provided the incidence of poly pharmacy and frequencies of prescribing of individual drug were analyzed. The data obtained were subsequently categorized systematically and analyzed by taking WHO guidelines into consideration. Results: The most commonly prescribed drugs were vitamins and tonics (57.5%) followed by anti-microbial agents (12.7%), non-steroidal anti-inflammatory drugs (10.5%), anti-hypertensive (5.2%), anti cough remedies and acid peptic disease drugs. Generic drug prescription was very low as most of drugs prescribed were proprietary. A low number of Fixed Dose Combinations (FDCs) were prescribed, this finding was in accordance with the WHO recommended list of FDCs. Items on the WHO model list of essential drugs were prescribed frequently. The use of drugs has been found to be in accordance with the disease, the patient had. Conclusions: Present study highlighted that there was a high incidence of irrational prescribing practice that increased with the total number of drugs per prescription.