BackgroundThe global rise and spread of antibiotic resistance is limiting the usefulness of antibiotics in the prevention and treatment of infectious diseases. The use of antibiotic stewardship programs guided by local data on prescribing practices is a useful strategy to control and reduce antibiotic resistance. Our objective in this study was to determine the prevalence and indications for use of antibiotics at the Korle-Bu Teaching Hospital Accra, Ghana.MethodsAn antibiotic point prevalence survey was conducted among inpatients of the Korle-Bu Teaching Hospital between February and March 2016. Folders and treatment charts of patients on admission at participating departments were reviewed for antibiotics administered or scheduled to be administered on the day of the survey. Data on indication for use were also collected. Prevalence of antibiotic use was determined by dividing the number of inpatients on antibiotics at the time of survey by the total number of patients on admission.ResultsOf the 677 inpatients surveyed, 348 (51.4%, 95% CI, 47.6–55.2) were on treatment with antibiotics. Prevalence was highest among Paediatric surgery where 20/22 patients (90.9%, 95% CI, 70.8–98.9) were administered antibiotics and lowest among Obstetrics patients with 77/214 (36%, 95% CI, 29.5–42.8). The indications for antibiotic use were 245/611 (40.1%) for community-acquired infections, 205/611 (33.6%) for surgical prophylaxis, 129/611 (21.1%) for healthcare associated infections and 33/611 (5.4%) for medical prophylaxis. The top five antibiotics prescribed in the hospital were metronidazole 107 (17.5%), amoxicillin-clavulinic acid 82 (13.4%), ceftriaxone 17(12.1%), cefuroxime 61 (10.0%), and cloxacillin 52 (8.5%) respectively. Prevalence of meropenem and vancomycin use was 12(2%) and 1 (.2%) respectively. The majority of patients 181 (52%) were being treated with two antibiotics.ConclusionThis study indicated a high prevalence of antibiotic use among inpatients at the Korle-Bu Teaching Hospital. Metronidazole was the most commonly used antibiotic; mainly for surgical prophylaxis. There is the need to further explore factors contributing to the high prevalence of antibiotic use and develop strategies for appropriate antibiotic use in the hospital.Electronic supplementary materialThe online version of this article (10.1186/s13756-018-0299-z) contains supplementary material, which is available to authorized users.

BackgroundUnderstanding the knowledge, attitudes and practices of physicians towards antibiotic resistance is key to developing interventions aimed at behavior change. The survey aimed to investigate physicians’ knowledge and attitudes towards antibiotic resistance in a tertiary-care hospital setting in Ghana.MethodsWe conducted a cross-sectional respondent-driven survey using a 40-item, anonymous, voluntary, traditional paper-and-pencil self-administered questionnaire among 159 physicians at Korle-Bu Teaching Hospital. Single and multi-factor analysis were conducted to assess the study objectives.ResultsThe survey was completed by 159 of 200 physicians (response rate of 79.5%). Of physicians, 30.1% (47/156) perceived antibiotic resistance as very important global problem, 18.5% (29/157) perceived it as very important national problem and only 8.9% (14/157) thought it as a very important problem in their hospital. Methicillin resistant Staphylococcus aureus was the most known about antibiotic resistant bacteria of public health importance followed by extended-spectrum beta-lactamase-producing Enterobacteriaceae, carbapenem resistant Enterobacteriaceae (CRE) and vancomycin resistant enterococci (VRE). In multiple logistic regression analysis, senior physicians were nearly 3 times more likely to know about CRE than junior physicians. The odds of knowing about VRE increased over 4.5 times from being a junior to becoming senior physician. Among junior physicians, age had no associated effect on their knowledge of VRE or CRE.ConclusionsPhysicians in this survey showed variable knowledge and perceptions on antibiotic resistance. Introducing educational programs on antibiotic resistance would be a useful intervention and should focus on junior physicians.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-2899-y) contains supplementary material, which is available to authorized users.

SummaryBackgroundSeveral factors have been identified that influence physicians' prescribing habits. The influence of physician's specialty has not been studied. This study is to determine if there are differences in the prescribing patterns amongst these various specialities that run a general medicine clinic at a tertiary hospital in Ghana.MethodsData collected from the out-patients clinic attendance records were analysed using WHO Rational Use of Medicines indicators. Analysis of Variance Test was carried out to establish if there was any variance in the prescribing indicators amongst 4 units of Physicians.Results678 patient encounters were utilised for this study. The average number of drugs prescribed per encounter was 4.4, drugs prescribed by generic name was 86.9%, patient encounters in which antibiotics prescribed were 6.5% (n= 44) and injections were prescribed in 3.2% (n=22) of patient encounters. 64.0% of all drugs prescribed were from the Ghanaian EML. The unit of the physician did not have a significant effect on the average number of medicines prescribed per patient encounter (F (3, 674) = 2.19, p = 0.088), and the percentage of medicines that were prescribed from the Essential Medicines List (F (3, 674) = 1.52, p = 0.207). The unit the physician belonged to however did have a significant effect at p < 0.05 on the prescription of generic medications (F (3, 674) = 4.79, p = 0.003).ConclusionThe physician units did not differ in their prescribing patterns at the general medicine clinic except for prescription of drugs by their generic names.FundingNone declared