Assessment of prescribing patterns of antibiotics using National Treatment Guidelines and World Health Organization prescribing indicators at the Ghana Police Hospital: a pilot study

Darkwah, Thomas Opoku; Afriyie, Daniel Kwame; Sneddon, Jacqueline; Cockburn, Alison; Opare-Addo, Mercy Naa Aduele; Tagoe, Benjamin; Amponsah, Seth Kwabena

doi:10.11604/pamj.2021.39.222.29569

Cited by 20 publications

(23 citation statements)

References 20 publications

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“…Our findings revealed that most caregivers were aware of the time to give antibiotics and are consistent with a study in China where the participants demonstrated ambivalent attitudes towards compliance and completion of antimicrobial therapy and this discrepancy suggests that individuals would follow instructions on dosing regimens but not treatment duration [27]. Inadequate knowledge about the importance of completing antimicrobial therapy and awareness of antibiotics has been reported in several studies in Africa [27,40]. We recommend that adequate information coupled with the right messages on the use of antibiotics and its consequences must be made aware to the public through the media, churches, and hospitals [41].…”

Section: Discussionsupporting

confidence: 90%

“I don’t hesitate to use the left-over antibiotics for my child” practices and experiences with antibiotic use among caregivers of paediatric patients at Zomba central hospital in Malawi

Machongo

Mipando

2022

BMC Pediatr

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Background Inappropriate use of antibiotics is among the major causes of the global emergency of antibiotic resistance among children. The problem of inappropriate use of antibiotics among children is of special concern because they are still developing immunological systems, hence they are susceptible to many infectious diseases. As such, they receive a considerable disproportional amount of antibiotics which exposes them to antibiotic resistance. This study explored the lived experiences of caregivers of children under the age of five years on the use of antibiotics at Zomba central hospital. Objective The main aim of this study was to explore the lived experiences of caregivers of children under the age of five years on antibiotic usage at Zomba Central Hospital, Zomba-Malawi. Methodology This was a descriptive qualitative study with a phenomenological approach to explore the lived experience of caregivers of paediatric patients on antibiotic usage from May 2019 to July 2020. The study used interview guides to conduct in-depth interviews with 16 caregivers and purposive sampling was used to select the participants from the children’s ward. All interviews were audio-recorded and qualitative data was transcribed verbatim and thematically analysed manually to extract major themes and concepts on the subject matter. Results Caregivers had little knowledge about antibiotic use and its resistance. most caregivers use the antibiotics inappropriately through self-medication, use of left-over antibiotics, buying antibiotics without prescription, and sharing of antibiotics. Conclusion Based on the findings of this study, investment in public awareness and organising community-led interventions in antibiotic use related information is key to improve the quality use of antibiotics. The Government should focus on promoting interventions that lessen the indiscriminate use of antibiotics among the caregivers. Stringent laws need to be enforced by the government to restrict the access of antibiotics to parents without a prescription.

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Section: Discussionsupporting

confidence: 90%

“I don’t hesitate to use the left-over antibiotics for my child” practices and experiences with antibiotic use among caregivers of paediatric patients at Zomba central hospital in Malawi

Machongo

Mipando

2022

BMC Pediatr

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“…Several studies have reported on the rate of antibiotic prescribing in different countries including Ghana in both inpatient and outpatient settings ranging from 34% to 82% [ 22 , 23 , 24 , 25 , 26 , 27 ]. However, the studies that were conducted in Ghana focused on specific regions and only provided snapshots of the rate of antibiotic prescribing in outpatient settings of those regions [ 28 , 29 , 30 ]. There are no studies conducted among outpatients in the Ashanti region of Ghana where a stewardship programme among inpatients is under implementation in the University Hospital of Kwame Nkrumah University of Science and Technology (KNUST).…”

Section: Introductionmentioning

confidence: 99%

High Levels of Outpatient Antibiotic Prescription at a District Hospital in Ghana: Results of a Cross Sectional Study

Amponsah

Nagaraja

Ayisi-Boateng

et al. 2022

IJERPH

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Background: Monitoring of antibiotic prescription practices in hospitals is essential to assess and facilitate appropriate use. This is relevant to halt the progression of antimicrobial resistance. Methods: Assessment of antibiotic prescribing patterns and completeness of antibiotic prescriptions among out-patients in 2021 was conducted at the University Hospital of Kwame Nkrumah University of Science and Technology in the Ashanti region of Ghana. We reviewed electronic medical records (EMR) of 49,660 patients who had 110,280 encounters in the year. Results: The patient encounters yielded 350,149 prescriptions. Every month, 33–36% of patient encounters resulted in antibiotic prescription, higher than the World Health Organization’s (WHO) recommended optimum of 27%. Almost half of the antibiotics prescribed belonged to WHO’s Watch group. Amoxicillin–clavulanic acid (50%), azithromycin (29%), ciprofloxacin (28%), metronidazole (21%), and cefuroxime (20%) were the most prescribed antibiotics. Antibiotic prescribing parameters (indication, name of drug, duration, dose, route, and frequency) were documented in almost all prescriptions. Conclusions: Extending antimicrobial stewardship to the out-patient settings by developing standard treatment guidelines, an out-patient specific drug formulary, and antibiograms can promote rational antibiotic use at the hospital. The EMR system of the hospital is a valuable tool for monitoring prescriptions that can be leveraged for future audits.

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“…Two hospitals in Ghana were the setting for this study: One is a 100-bed hospital in Accra (Ghana’s capital city), and the other is a 110-bed government hospital in a rural area within the Volta Region. These hospitals were selected due to their involvement in a previous AMS project and previous studies of dental antibiotic use [ 13 , 14 ].…”

Section: Methodsmentioning

confidence: 99%

“…Ghana is a middle-income country, and the two hospitals involved in this study have delivered successful AMS programmes [ 12 ]. Whilst dentistry was not included in either of these AMS programmes, recent audits in both hospitals found high rates of dental antibiotic use: dental teams were the highest prescribers of antibiotics, responsible for >20% of antibiotics prescribed in one hospital [ 13 ]. The audits also found high rates of antibiotic misuse: nearly 90% of dental patients in an-other hospital received an antibiotic, of which 88% were non-compliant with national standard treatment guidelines [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring the Use of Antibiotics for Dental Patients in a Middle-Income Country: Interviews with Clinicians in Two Ghanaian Hospitals

et al. 2022

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Background: Antimicrobial resistance is a global problem driven by the overuse of antibiotics. Dentists are responsible for about 10% of antibiotics usage across healthcare worldwide. Factors influencing dental antibiotic prescribing are numerous, with some differences in low- and middle-income countries compared with high-income countries. This study aimed to explore the antibiotic prescribing behaviour and knowledge of teams treating dental patients in two Ghanaian hospitals. Methods: Qualitative interviews were undertaken with dentists, pharmacists, and other healthcare team members at two hospitals in urban and rural locations. Thematic and behaviour analyses using the Actor, Action, Context, Target, Time framework were undertaken. Results: Knowledge about ‘antimicrobial resistance and antibiotic stewardship’ and ‘people and places’ were identified themes. Influences on dental prescribing decisions related to the organisational context (such as the hierarchical influence of colleagues and availability of specific antibiotics in the hospital setting), clinical issues (such as therapeutic versus prophylactic indications and availability of sterile dental instruments), and patient issues such as hygiene in the home environment, delays in seeking professional help, ability to access antibiotics in the community without a prescription and patient’s ability to pay for the complete prescription. Conclusions: This work provides new evidence on behavioural factors influencing dental antibiotic prescribing, including resource constraints which affect the availability of certain antibiotics and diagnostic tests. Further research is required to fully understand their influence and inform the development of new approaches to optimising antibiotic use by dentists in Ghana and potentially other low- and middle-income countries.

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Assessment of prescribing patterns of antibiotics using National Treatment Guidelines and World Health Organization prescribing indicators at the Ghana Police Hospital: a pilot study

Cited by 20 publications

References 20 publications

“I don’t hesitate to use the left-over antibiotics for my child” practices and experiences with antibiotic use among caregivers of paediatric patients at Zomba central hospital in Malawi

“I don’t hesitate to use the left-over antibiotics for my child” practices and experiences with antibiotic use among caregivers of paediatric patients at Zomba central hospital in Malawi

High Levels of Outpatient Antibiotic Prescription at a District Hospital in Ghana: Results of a Cross Sectional Study

Exploring the Use of Antibiotics for Dental Patients in a Middle-Income Country: Interviews with Clinicians in Two Ghanaian Hospitals

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