Evaluation of Prescribing Patterns and Supportive Therapy in Dengue Patients: A Retrospective Observational Study in a Tertiary Care Hospital

Background: Dengue is a significant public health concern in tropical countries, and its management primarily involves supportive care. Evaluating drug utilization patterns and prescribing appropriateness is essential to identify irrational prescribing, promote antimicrobial stewardship, and improve patient safety. Objective: To evaluate prescribing patterns, the utilization and appropriateness of supportive therapy, and selected clinical outcomes among hospitalized patients with dengue. Methods: A retrospective observational study was conducted among 95 patients with serologically confirmed dengue admitted to the Department of General Medicine at Valluvanad Hospital, Ottapalam, Kerala, from January to June 2026. Data were collected from medical records, laboratory reports, and patient case sheets. Prescribing patterns were assessed using WHO core prescribing indicators, wherever applicable. The appropriateness of antibiotic use, intravenous fluid therapy, platelet transfusions, NSAIDs, corticosteroids, and hepatoprotective agents was evaluated using predefined criteria and relevant treatment guidelines. Data were analysed using IBM SPSS Statistics version 29.0. Appropriate statistical tests were applied, and a p-value of less than 0.05 was considered statistically significant. Results: Intravenous fluids were administered to 97.89% of patients, followed by antiemetics (91.58%). Antibiotics were prescribed to 53.68% of patients, with cephalosporins being the most frequently reported antibiotic class (64.7% of antibiotic prescriptions). Corticosteroids and hepatoprotective agents were prescribed to 38.95% and 35.79% of patients, respectively. Platelet transfusions were administered to 16.84% of patients and were classified as appropriate in all cases. NSAID use was low (3.16%), while intravenous fluid therapy was considered appropriate in 98.95% of cases. The mean number of medicines per prescription was 6.63, and generic prescribing accounted for 26.03%. Overall, 61.05% of prescriptions were classified as rational, whereas 38.95% were considered irrational. Length of hospital stay increased with dengue severity, with median stays of 3, 4, and 5 days among patients without warning signs, with warning signs, and with severe dengue, respectively. This difference was statistically significant (H = 10.23, p = 0.006). Conclusion: The study demonstrated predominantly supportive management of hospitalized dengue patients, with high appropriateness of intravenous fluid therapy and platelet transfusion decisions. However, substantial antibiotic exposure, frequent use of adjunctive medications, polypharmacy, and limited generic prescribing indicate opportunities to improve rational pharmacotherapy. Strengthening antimicrobial stewardship, reviewing medication indications, and promoting guideline-based prescribing may enhance the quality and safety of dengue management.