Antibiotic prescription pattern in a Ghanaian primary health care facility

Abstract

IntroductionA major challenge to the provision of health care worldwide is the irrational use of antibiotics. To help promote rational use of drugs, standard treatment guidelines (STG) and essential medicine lists and facility-specific formularies have been developed to be used by clinicians. This study assessed the prescription pattern of antibiotics and explored the use of STG by clinicians.MethodsA prospective cross sectional study that made use of seven core drug use indicators was conducted from February, 2017 to July, 2017. Prescribing indicators were assessed using 388 prescriptions that were submitted for filling and dispensing at the pharmacy unit of the hospital. Clinicians were interviewed to assess their use of STG. Data were analyzed using SPSS version 20.0 with a p-value of < 0.05 considered as statistically significant.ResultsA total of 1351 drugs were prescribed for 388 patients. The average number of medicines per prescription was 3.5. Of the 388 prescriptions, 55.2% bore antibiotics, with amoxicillin (22.5%) and ciprofloxacin (18.4%) being the most prescribed antibiotics. Patients' knowledge about their medications was found to be significantly associated with the number of drugs per prescription (p = 0.001), age (p = 0.015) and educational level (p = 0.001). Only 41.7% of prescribers had copies of STG and used them.ConclusionThe prescribing and dispensing practices in the hospital were generally not satisfactory with a low patronage of STG among prescribers. In order to improve the situation, clinicians should practice evidence based medicine rather than empirical treatment of conditions as well as use the STG in practice.

<p>Prescribing Pattern of Antibiotics Using WHO Prescribing Indicators Among Inpatients in Ethiopia: A Need for Antibiotic Stewardship Program</p>

“…1 This shows a high rate of antibiotic prescription in our hospital. This figure was similar to those observed in previous studies, including 48.5% in Gondar town, Ethiopia, 36 55.2% in Ghana, 37 51.0% in Nigeria, 38 51.5% in Pakistan, 39 and 54.6% in China. 40 On the other hand, our prescribing rate of antibiotics was low compared to the results reported from other studies conducted in southwest Ethiopia (64.7%), 41 southern Ethiopia (58.1%), 23 and Harar, eastern Ethiopia (66.9%).…”

Improving antimicrobial stewardship in the outpatient department of a district general hospital in Sierra Leone

“…There is a comparative paucity of data on the appropriateness of antibiotic use in LMICs. A Ghanaian study suggested it was ‘not satisfactory’ as evidenced by a high proportion of patients in their OPD receiving antibiotics (55%) and the fact that the mean number of drugs prescribed was 3.5 with only 10% of their patients undergoing appropriate diagnostic testing 10. A Nigerian study quoted a similar figure of 51% of patients receiving antibiotics in the OPD 11.…”

Unnecessary antimicrobial prescribing for upper respiratory tract infections in children in Pietermaritzburg, South Africa

“…24 Therefore, the findings of this research suggest that it is in fact the majority of the prescribers, and not the parents/guardians (as it was anticipated), who are likely to exacerbate the challenge of multi-drug resistance due to irrational prescribing patterns. Lack or insufficient practice of evidence-based medicine and failure to adhere to the standard treatment guidelines among the various general practitioners have been reported in Ghana, 25 Sweden 26 and in many countries across the world. 27 This study has also identified residential area, ethnicity, parents' age, gender and educational level as significant factors associated with parents' knowledge and attitudes concerning judicious antibiotic use in children.…”