Assessment of Antibiotics Prescribing Practices at The Sunyani Municipal Hospital in 2015

ABSTRACT

INTRODUCTION: High use of antibiotics is associated with the emergence and spread of antibiotic resistance. Global antibiotics consumption has increased in recent years with an even more significant increase coming from developing countries. The Ministry of Health in Ghana estimates that the median prevalence of antibiotic prescribing in health facilities is 44.3% against a standard of 30%. The quarterly prevalence of antibiotic prescribing at the Sunyani Municipal Hospital outpatient department ranged from 57% to 67.5% in 2015. The objective of this study was to assess antibiotics prescribing practices at Sunyani Municipal Hospital in order to identify clinical and administrative factors of concern that need to be addressed. METHODS: A one year retrospective records review was designed for the assessment. Medical records of patients who were prescribed antibiotics upon their visit to the outpatient department from January to December, 2015 were reviewed and relevant data collected. The frequencies of prescribing antibiotics were recorded according to age, sex and diagnoses. Pearson’s Chi square test was used to assess the association between prescribing of broad-spectrum antibiotics and age, sex and diagnoses. T-test analysis was used to assess how the prescribed doses of antibiotics compare with the WHO DDD as well as the difference between recommended and prescribed days of therapy. Multiple logistic regression was used to determine the strength of association between prescribing recommended antibiotics and diagnoses as well as prescribing broad-spectrum antibiotics and diagnoses. RESULTS: The diagnosis most frequently treated with antibiotics was respiratory tract infection 25.9%. The proportion of broad-spectrum antibiotics prescribed was 48.2%. The average number of antibiotics per prescription was 1.20(SD=0.49). The vi proportion of antibiotics prescribed singly was 83% (95% CI: 79.0 – 86.4%). The proportion of antibiotics that made up the drug utilization 90% was 31.6%. Amoxicillin/Clavulanic acid and cefuroxime accounted for approximately 50% by volume of all antibiotics used. The mean defined daily dose prescribed at the outpatient department was greater than 1 [t(449)=12.17, p