Drug utilisation pattern among neonates admitted to a tertiary care neonatal intensive care unit: a prospective observational study

Background: Neonates in NICUs frequently require numerous medications because of severe illnesses and immature physiology. Drug utilization studies help identify prescribing trends and potential areas for enhancing rational pharmacotherapy. This research assessed drug utilization patterns among neonates in a tertiary care NICU, utilising World Health Organization (WHO) prescribing indicators. Methods: A prospective study over eight months (May–December 2025) was conducted in a NICU at a tertiary hospital in Gujarat, India. Neonates receiving at least one therapeutic medication and meeting eligibility criteria were enrolled. Demographic, clinical data, prescribed medications, therapeutic classes, and antibiotic use were recorded. Prescribing practices were assessed using WHO indicators, and drugs classified via the WHO ATC system. Results: A total of 302 neonates received 1581 prescribed medications, with an average of 5.23±2.93 drugs per encounter. Generic drugs made up 67.17%, and 79.32% of the medications were from the National List of Essential Medicines 2022. Antibiotics were prescribed in 85.10% of cases, and injections in all cases. Antibiotics represented the largest therapeutic category at 49.40%. The most frequently prescribed drugs were calcium gluconate (81.13%), piperacillin–tazobactam (73.51%), and gentamicin (66.89%). No significant differences were found between preterm and full-term neonates regarding the average number of medications, antibiotic use, or length of hospital stay. Conclusions: The prescribing pattern reflected the clinical complexity of neonates requiring intensive care, with substantial use of antibiotics and supportive medications. Regular drug utilisation monitoring and antimicrobial stewardship may help promote rational and safe pharmacotherapy in NICUs.