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GCP. JOURNAL

A Retrospetive evaluation of antibiotic prescription at out-patients department at Tema polyclinic, Ghana

Abstract
The excessive and irrational consumption of antibioticsis amajor driverforthe emergence of antimicrobialresistance. Itistherefore, 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 fromtheOPDregisterforthe period 1st January to 30th June, 2019. Sociodemographic characteristics of patients,signs and symptoms presented, and diagnoses made were recorded. Data on dose, frequency and duration oftreatmentfor allmedicines given were also recorded. Frequencies and proportions wereused 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) asthe top three classesfrom 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 wassignificantly associated with age (p < 0.009), category of prescriber(p < 0.001), occupation (p = 0.03),maritalstatus(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 isthe need to strengthen antibiotic stewardship at the polyclinic to ensure appropriate prescribing and adherence to STG.

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