International Journal of Pharma and Bio Sciences
    ISSN 0975-6299

Int J Pharm Bio Sci Volume 14 Issue 2, April-June, Pages:12-20

Drug Utilization Pattern Among COVID-19 Patients in A Tertiary Care Centre: An Observational Study

Dr. Ramya Rachamanti, Dr Rajesh Dupaguntla, and Dr Solomon Raju. K

Drug utilization study was defined by the World Health Organization as the study of marketing, distribution, prescription, and use of drugs in a society, with special emphasis on medical, social, and economic consequences. The coronavirus disease 2019 (COVID-19) outbreak has quickly swept across the world and has been declared a Public Health Emergency of International Concern. There were 4.47 crores of COVID-19 cases in India, with 5.3 lakhs of deaths as of Dec 23, 2022. However, only a few studies evaluated the pattern of use of drugs among patients with COVID-19 in India. Hence, the current study analyzed the drug utilization pattern among COVID-19 patients at our tertiary care center (GMC/GGH) in Ongole, Andhra Pradesh, India. It is an observational, retrospective study. Case records of 100 patients coming to OP or admitted at our tertiary care center with COVID-19 from March to December 2021 were taken as the study sample. Fifty patients belonged to group A (asymptomatic and mild COVID-19 and 50 patients belonged to group B (moderate and severe COVID-19). Drug utilization pattern was assessed using the World Health Organization indicators. A total of 859 drugs were prescribed for 100 patients. Among them, 249(28.9%) were antibiotics. 219(25%) were injections. 678(78.9%) were prescribed in generic names, and 745(81%) drugs were prescribed from the national list of essential medicines of 2022. There is a significant difference in all 5 WHO indicators between groups A and B. There is a knowledge gap in many drugs used to treat COVID-19. Evidence-based pharmacotherapy for patients with COVID-19 is vital to enhance valuable healthcare resources during the pandemic. The information derived from this research work will be handed over to the stakeholders for implementing modifications wherever needed to improve clinical outcomes.

Keywords: COVID-19, Drug utilization pattern, WHO indicators, Remdesivir, Tocilizumab
Full HTML:
  1. WHO. Definitions. Chapter 1.1. Who. Int [Internet] [cited Dec 23, 2022]. Available from:
  2. INDIA MYGOV. #IndiaFightsCorona COVID-19 [Internet]; 2020. [cited Dec 23, 2022]. Available from:
  3. Lu R, Zhao X, Li J, Niu P, Yang B, Wu H et al. Genomic characterization and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020 Feb 22;395(10224):565-74. doi: 10.1016/S0140-6736(20)30251-8. PMID 32007145, PMCID PMC7159086.
  4. Serafim RB, Póvoa P, Souza-Dantas V, Kalil AC, Salluh JIF. Clinical course and outcomes of critically ill patients with COVID-19 infection: A systematic review. Clin Microbiol Infect. 2021;27(1):47-54. doi: 10.1016/j.cmi.2020.10.017. (PMC Free article). PMID 33190794 [CrossRef], Google Scholar.
  5. Tan E, Song J, Deane AM, Plummer MP. Global impact of coronavirus disease 2019 infection requiring admission to the ICU: A systematic review and meta-analysis. Chest. 2021;159(2):524-36. doi: 10.1016/j.chest.2020.10.014. (PMC Free article). PMID 33069725 [CrossRef], Google Scholar.
  6. Wu SS, Zhou QX, Zeng XY, Zhang JX, Yang ZR, Yang QQ, et al. Comparative effectiveness and safety of 32 pharmacological interventions recommended by guidelines for coronavirus disease 2019: A systematic review and network meta-analysis combining 66 trials. Chin Med J (Engl). 2021;134(16):1920-9. doi: 10.1097/CM9.0000000000001672. (PMC Free article). PMID 34320566 [CrossRef], Google Scholar.
  7. Abeldaño Zuñiga RA, Coca SM, Abeldaño GF, González-Villoria RAM. Clinical effectiveness of drugs in hospitalized patients with COVID-19: A systematic review and meta-analysis. Ther Adv Respir Dis. 2021;15:17534666211007214. doi: 10.1177/17534666211007214. (PMC Free article). PMID 33765902 [CrossRef]. Google Scholar.
  8. Rajaiah R, Abhilasha KV, Shekar MA, Vogel SN, Vishwanath BS. Evaluation of mechanisms of action of re-purposed drugs for the treatment of COVID-19. Cell Immunol. 2020;358:104240. doi: 10.1016/j.cellimm.2020.104240. (PMC Free article). PMID 33137649 [CrossRef], Google Scholar.
  9. Yousefi H, Mashouri L, Okpechi SC, Alahari N, Alahari SK. Repurposing existing drugs for treating COVID-19/SARS-CoV-2 infection: a review describing drug mechanisms of action. Biochem Pharmacol. 2021;183:114296. doi: 10.1016/j.bcp.2020.114296. (PMC Free article). PMID 33191206 [CrossRef], Google Scholar.
  10. Diaz-Arocutipa C, Brañez-Condorena A, Hernandez AV. QTc prolongation in COVID-19 patients treated with hydroxychloroquine, chloroquine, azithromycin, or lopinavir/ritonavir: A systematic review and meta-analysis. Pharmacoepidemiol Drug Saf. 2021;30(6):694-706. doi: 10.1002/pds.5234. (PMC Free article). PMID 33772933 [CrossRef], Google Scholar.
  11. Awortwe C, Cascorbi I. Meta-analysis on outcome-worsening comorbidities of COVID-19 and related potential drug-drug interactions. Pharmacol Res. 2020;161:105250. doi: 10.1016/j.phrs.2020.105250. (PMC Free article). PMID 33059010 [CrossRef], Google Scholar.
  12. Lebrasseur A, Fortin-Bédard N, Lettre J, Raymond E, Bussières EL, Lapierre N et al. Impact of the COVID-19 pandemic on older adults: a rapid review. JMIR Aging. 2021 Apr 12;4(2):e26474. doi: 10.2196/26474, PMID 33720839, PMCID PMC8043147.
  13. Liu H, Chen S, Liu M, Nie H, Lu H. Comorbid chronic diseases are strongly correlated with disease severity among COVID-19 patients: A systematic review and meta-analysis. Aging Dis. 2020 May 9;11(3):668-78. doi: 10.14336/AD.2020.0502, PMID 32489711, PMCID PMC7220287.
  14. Singh TU, Parida S, Lingaraju MC, Kesavan M, Kumar D, Singh RK. Drug repurposing approach to fighting COVID-19. Pharmacol Rep. 2020;72(6):1479-508. (PMC Free article). doi: 10.1007/s43440-020-00155-6, PMID 32889701.
  15. Gov. in [cited Dec 23, 2022]. Available from:
  16. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020 Mar 17;323(11):1061-9. doi: 10.1001/jama.2020.1585. Erratum in: JAMA. 2021 Mar 16;325(11):1113. PMID 32031570, PMCID PMC7042881.
  17. Murhekar MV, Bhatnagar T, Selvaraju S, Rade K, Saravanakumar V, Vivian Thangaraj JW et al. Rade, Kiran, et al. Prevalence of SARS-CoV-2 infection in India: findings from the national serosurvey, May-June 2020. Indian J Med Res. 2020;152(1-2):48-60. doi: 10.4103/ijmr.IJMR_3290_20, PMID 32952144.
  18. Clinical spectrum [Internet]. COVID-19 treatment guidelines [cited Dec 24 2022]. Available from:
  19. Who. int [cited Dec 24, 2022]. Available from:
  20. Gov. in [cited Jan 11, 2023]. Available from:
  21. Orlando V, Coscioni E, Guarino I, Mucherino S, Perrella A, Trama U et al. Drug-utilisation profiles and COVID-19. Sci Rep. 2021 Apr 26;11(1):8913. doi: 10.1038/s41598-021-88398-y, PMID 33903671, PMCID PMC8076316.
  22. Mustafa ZU, Kow CS, Salman M, Kanwal M, Riaz MB, Parveen S et al. The pattern of medication utilization in hospitalized patients with COVID-19 in three District Headquarters Hospitals in the Punjab Province of Pakistan. Explor Res Clin Soc Pharm. 2022 Mar;5:100101. doi: 10.1016/j.rcsop.2021.100101. PMID 34977851, PMCID PMC8715623.
  23. Recovery Collaborative Group, Horby P, Lim WS, Emberson JR, Mafham M, Bell JL, et al. Dexamethasone in hospitalized patients with Covid-19. N Engl J Med. 2021;384(8):693-704. (PMC Free article). doi: 10.1056/NEJMoa2021436, PMID 32678530.
  24. Sun F, Kou H, Wang S, Lu Y, Zhao H, Li W et al. An analytical study of drug utilization, disease progression, and adverse events among 165 COVID-19 patients. Ann Transl Med. 2021;9(4):306. doi: 10.21037/atm-20-4960, PMID 33708933.
  25. Langford BJ, So M, Raybardhan S, Leung V, Soucy JR, Westwood D, et al. Antibiotic prescribing in patients with COVID-19: rapid review and meta-analysis. Clin Microbiol Infect. 2021;27(4):520-31. (PMC Free article). doi: 10.1016/j.cmi.2020.12.018, PMID 33418017.
  26. REMAP-CAP Investigators, ACTIV-4a Investigators, ATTACC Investigators, Goligher EC, Bradbury CA, McVerry BJ, et al. Therapeutic Anticoagulation with heparin in Critically Ill Patients with Covid-19. N Engl J Med. 2021;385(9):777-89. (PMC Free article). doi: 10.1056/NEJMoa2103417, PMID 34351722.
  27. ATTACC Investigators, ACTIV-4a Investigators, REMAP-CAP Investigators, Lawler PR, Goligher EC, Berger JS, et al. Therapeutic Anticoagulation with heparin in Noncritically Ill Patients with Covid-19. N Engl J Med. 2021;385(9):790-802. (PMC Free article). doi: 10.1056/NEJMoa2105911, PMID 34351721.
  28. Desalegn AA. Assessment of drug use pattern using WHO prescribing indicators at Hawassa University Teaching and Referral Hospital, south Ethiopia: a cross-sectional study. BMC Health Serv Res. 2013 May 7;13:170. doi: 10.1186/1472-6963-13-170, PMID 23647871, PMCID PMC3651314.
  29. Andrade C. Bioequivalence of generic drugs. J Clin Psychiatry. 2015;76(9):e1130-1. doi: 10.4088/JCP.15f10300, PMID 26455677.
  30. Yu Y, Teerenstra S, Neef C, Burger D, Maliepaard M. Investigation into the interchangeability of generic formulations using immunosuppressants and a broad selection of medicines. Eur J Clin Pharmacol. 2015;71(8):979-90. (PMC Free article). doi: 10.1007/s00228-015-1878-z, PMID 26062932.
  31. Privitera MD, Welty TE, Gidal BE, Diaz FJ, Krebill R, Szaflarski JP, et al. Generic-to-generic lamotrigine switches in people with epilepsy: the randomized controlled EQUIGEN trial. Lancet Neurol. 2016;15(4):365-72. doi: 10.1016/S1474-4422(16)00014-4, PMID 26875743.
  32. Gagne JJ, Polinski JM, Jiang W, Dutcher SK, Xie J, Lii J, et al. Outcomes associated with generic drugs approved using product-specific determinations of therapeutic equivalence. Drugs. 2017;77(4):427-33. doi: 10.1007/s40265-017-0696-2, PMID 28181177.
  33. Bhimraj A, Morgan RL, Shumaker AH, Lavergne V, Baden L, Cheng VC, et al. Infectious Diseases Society of America guidelines on treating and managing patients with COVID-19. Clin Infect Dis. 2020 Apr 27:ciaa478. doi: 10.1093/cid/ciaa478 [Epub ahead of print]. PMID 32338708, PMCID PMC7197612.
  34. National Institutes of Health. COVID-19 Treatment Guidelines Panel; 2019 (COVID-19) Treatment Guidelines. [(accessed on 11 Jan 2023)]. Coronavirus Disease. Available from:
  35. Stroever SJ, Ostapenko D, Scatena R, Pusztai D, Coritt L, Frimpong AA et al. Medication use among patients with COVID-19 in a large, national dataset: Cerner real-world Data™. Clin Ther. 2021;43(6):e173-96. doi: 10.1016/j.clinthera.2021.03.024. (PMC Free article). PMID 33958234 [CrossRef], Google Scholar.
  36. Best JH, Kong AM, Kaplan-Lewis E, Brawley OW, Baden R, Zazzali JL, et al. Treatment patterns in US patients hospitalized with COVID-19 and pulmonary involvement. J Med Virol. 2021;93(9):5367-75. doi: 10.1002/jmv.27049. (PMC Free article). PMID 33913536 [CrossRef], Google Scholar.



[Download PDF]
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy
Pharmaceutical Fields
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Pharmaceutics
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Novel drug delivery system
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Nanotechnology
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Pharmacology
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Pharmacognosy
© Copyright 2009-2015 IJPBS, India. All rights reserved. Specialized online journals by ubijournal. Website by Ubitech Solutions
         Home I Contact I Terms & Conditions