Prescription Practices and Patterns of Antibiotics used in Children Attending the Princess Marie Louise Children’s Hospital

Abstract

Introduction: Globally, antibiotic use in humans increased by 36% from 2000 to 2010, of which 50% was regarded as inappropriate use. There is high prevalence of antibiotic use in Ghana which is associated with inappropriate use.Whilst antibiotics use in developed countries reduced by 4% between 2000 and 2015 there was 75% increase in low and middle income countries during the same period. This may increase the potential for resistance developing against the antibiotics which may pose a great threat to public health.

Objectives: This study assessed prescription practices and pattern of antibiotics use in patients attending the Princess Marie Louise children’s hospital in Accra, Ghana. Methods: Folders of patients who had accessed care at the Princess Marie Children’s Hospital from 1st January 2013 to the 31st December 2015 were selected and reviewed. The antibiotic prescription practices and patterns in the hospital were assessed using the WHO guideline for assessing the average number of medicines prescribed per encounter, prescription by generic name, injections and prescription from the national essential medicine list. During assessment, descriptive analysis was made. Relationship between antibiotic use and indicators like diagnosis, age of patient and sex of patient were also analysed using the Pearson chi squared test. A pretested questionnaire was administered to prescribers to assess adherence to the Standard Treatment Guideline. Results: Out of the 422 folders reviewed Amoksiklav was the highest prescribed antibiotic (145) (34.7%) followed by Cefuroxime (98) (23.2%) and Augmentin (95) (22.5%). The major indication for antibiotic prescription was Upper Respiratory Tract Infection (146/422) (34.6%) and fevers (102/422) (24.2%). The average drug encounter per patient was 3.2. Drugs prescribed from the Essential Medicine List was 71.4%. There were no injectables. Of the ten prescribers interviewed, 8 (80 %) had the Standard Treatment Guideline, 4 (40 %) used it regularly and 7 (70 %) prescribed an antibiotic before further investigation were done. A prescribed gave antibiotics to patients depending on the severity of presenting ailment.

Conclusion The study showed that majority the study population were below 5 years and most of prescribers interviewed prescribed an antibiotic before further investigation was conducted. This has serious public health implications as some of the children whose condition will not require an antibiotic would be given antibiotic and potentially increase antibiotic resistance. The use of Who Core Drug Indicators was commendable