A retrospective evaluation of antibiotic prescriptions at out-patients department at Tema Polyclinic, Ghana

The excessive and irrational consumption of antibiotics is a major driver for the emergence of antimicrobial resistance. It is therefore, important to monitor and evaluate their use on regular basis, especially at the primary care level to ensure that they are being appropriately used to safeguard their efficacy over a longer period. The study was aimed at evaluating prescriptions of antibiotics at the outpatients department of Tema Polyclinic, Ghana. Records of 470 outpatients were obtained by systematic random sampling from the OPD register for the period 1″January to 30 “June, 2019. Sociodemographic characteristics of patients, signs and symptoms presented, and diagnoses made were recorded. Data on dose, frequency and duration of treatment for all medicines given were also recorded. Frequencies and proportions were used to determine antibiotic prescriptions,types prescribed, prescribing indicators and demographic variables (at 95% confidence interval). Pearson’s Chi-square was used to identify possible associations between antibiotic prescription and other variables. Antibiotics were prescribed for 54.9% of patients (n=258) with Penicillins (47.5%, n=142), Cephalosporins (15.4%, n=46) and Quinolones (15.1%, n=45) as the top three classes from which antibiotics were prescribed. Most frequently prescribed specific antibiotics were: amoxicillin (20.7%, n=62), co-amoxiclav (18.4%, n=55), ciprofloxacin (15.1%, n=45), cefuroxime (9.7%, n=29) and flucloxacillin (8.4%, n=25). Urinary tract infections (UTI) (13.6%, n=35), enteric fever (6.2%, n=160, respiratory tract infections (RTI) (6.2%, n=16) and gastroenteritis (4.7%, n=12) were the diagnoses for which most antibiotics were prescribed. Antibiotic prescription was significantly associated with age [p < 0.009), category of prescriber [p < 0.001), occupation [p = 0.03), marital status [p —— 0.022) and the following diagnoses: UTI \p —— 0.001), enteric fever (p– 0.001), RTI (p=0.013) and furunculosis (p=0.002). The appropriateness of antibiotic choice for specified diagnosis as stated in the standard treatment guideline (STG) was 78.3% (n=173). Of this, 87.9% (n=152), 94.8% (n=164) and 71.7% (n=124) respectively, were appropriate for antibiotic dose, frequency and duration of treatment. There is the need to strengthen antibiotic stewardship at the polyclinic to ensure appropriate prescribing and adherence to STG.

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