PRESCRIBING PATTERN IN CHILDREN WITH SEIZURES: A CROSS-SECTIONAL STUDY IN A PEDIATRIC INTENSIVE CARE UNIT OF A TERTIARY CARE HOSPITAL, MANDYA, KARNATAKA, INDIA

Background: Seizure is defined as an abrupt and transient disturbance of neurological function brought on by an excessive and coordinated firing of neurons in the brain. The ILAE standards divide seizures into three types: generalized, focal, and undetermined onset. Generalized seizures are caused by neural networks in both hemispheres and can be characterized as absence, generalized tonic-clonic, myoclonic, or atonic.  Seizures with an unknown onset may begin in a specific area of one cerebral hemisphere. Facilitating rational drug usage in communities is the main goal of drug use research. For each patient, rational drug usage means prescribing a well-researched medication at an appropriate dosage for the appropriate indication, with the relevant information, and a reasonable cost. 
Objective: The aim of the study was to analyze and evaluate prescribing pattern in Intensive Care Unit of Pediatrics. 
Methods and methodology: A Cross-sectional study was conducted: In-patients who are getting treated in PICU who met the inclusion and exclusion criteria has been included in the study. 
Results: This study analyzed 150 prescriptions, of which 65.8% were male and 46.5% were aged 1 month–<2 years. Simple febrile seizures were most common (65.78%), followed by breakthrough seizures (19.73%). A family history of consanguinity was present in 15.78%. Among 235 antiepileptic drugs prescribed, clobazam (42.1%) and levetiracetam (39.47%) were most frequent, with tablets (48.24%) being the predominant formulation. Monotherapy was used in 63.15% of cases. Previous hospitalization was reported in 38.2%, while 58.55% required 4–6 days of hospital stay. Co-morbidities were observed in 35.52%, mainly anemia (33.33%) and dehydration (20.37%). Antibiotics were prescribed in 38.15% of patients, with ceftriaxone being most common (54.76%). WHO core indicators showed a higher average number of drugs per encounter (2.10), greater antibiotic (38.2%) and injection use (34.2%), and no prescriptions by generic name or from the Essential Medicines List. 
Conclusion: The study highlights those simple febrile seizures were the most common presentation, with clobazam and levetiracetam being the most frequently prescribed AEDs. Monotherapy was preferred, though antibiotic and injection use were higher than WHO recommendations. Co-morbidities such as anaemia and dehydration were common. Overall, the findings emphasize the need for rational prescribing and adherence to WHO indicators in PICU settings.