Availability of antifungal eye drops in hospital and private retail pharmacies: a survey conducted in Kumasi, Ghana

Abstract

Oculomycosis is a fungal infection of the eye which commonly manifests itself as exogenous or endogenous endophthalmitis, and keratomycosis. 1,2 The incidence of oculomycosis is higher; in tropical and semitropical areas of the world, and with warmer temperatures, rampant rainfall, windy seasons, and harvest periods. 3,4 It is more common among the agricultural population, and is responsible for 4-60% of cases of corneal ulcers in tropical areas. 5-7 In Ghana it accounts for 36.7% of corneal ulcers. 3 Reports on oculomycosis globally has increased in recent ABSTRACT Background: Effective treatment of oculomycosis involves the use of antifungal eye drops in addition to systemic antifungal medications. The aim of this study therefore was to ascertain the availability of antifungal eye drops in hospital and private retail pharmacies in Kumasi, in the Ashanti Region of Ghana. Methods: A cross-sectional survey using a structured questionnaire to obtain information on stocking of antifungal eye drops was administered to workers in 99 randomly selected pharmacies in Kumasi between January-June, 2015. Results: Respondents sampled from the pharmacies were: Pharmacists (37.4%), Medicine counter assistants (36.4%), and Pharmacy technicians (26.3%). Although none of the pharmacies visited had antifungal eye drops (AEDs) in stock, 25 (25.3%) had stocked these before; 18 (72%) stocked fluconazole while 7 (28%) stocked natamycin (17 (68%) indicated fluconazole to be the most patronised). The stocking pattern was not regular as 16 (64%) only stocked on demand. 51.5% the acquired AEDs from local importers of pharmaceutical medicines while 48.5% imported them by themselves. For the 74 (73.7%) pharmacies that did not stock, 60 (80.8%) indicated that AEDs were not NHIS-approved medicines, 51 (68.9%) indicated unavailability from wholesalers to stock, and another 27 (36.4%) indicated that prescriptions were rarely received at the pharmacies. Majority 71.7% of the respondents perceived AEDs to be scarce in Ghana. Conclusions: Antifungal eye drops are unavailable in hospital and private retail pharmacies in Kumasi, and is perceived to be scarce in Ghana.

Elucidating fungal etiology and multi-drug resistance in oculomycosis and bioprospecting native medical plants as candidates for antifungal therapy

“…Of note, antifungal agents available for treating fungi infections such as oculomycosis include polyenes (natamycin, nystatin, and amphotericin B), allylamines (terbina ne), azoles ( uconazole, itraconazole, voriconazole, posaconazole, and isavuconazole) and echinocandins classes 22 . Contrary to the echinocandins, the polyenes, allylamines, and azole class of antifungal medications are readily available and commonly used by clinicians, including eyecare professionals, for managing fungi infections in Ghana 23,24,25 . Current trends in medical and public health space show an increasing AMR and MDR to clinically used antimicrobial agents such as antifungals.…”