Irrational Use of Antibiotics in Children under Five in Community Pharmacies in the Accra Metropolis District

Abstract

Introduction: Antibiotics are by far the most common drugs administered to children. They account for about one-fourth of all medications administered to children, with a third of its use in children considered unnecessary. Due to the lack of education of both healthcare professionals and the general population, antibiotics are commonly used to treat a variety of viral infections including: the common cold, cough, sore throat and acute watery diarrhoea in children. Irrational use of antibiotics has long term consequences for children‟s health and could predispose them to early onset diabetes, hypertension and obesity. This study therefore seeks to examine factors associated with the community pharmacist‟s role in the irrational use of antibiotics in children under five in the Accra Metropolis. Objective: To examine factors associated with the community pharmacist‟s role in the irrational use of antibiotics in children under five. Method: A cross sectional study using a quantitative approach. It was conducted by administering questionnaires to pharmacists and pharmacy assistants at community pharmacies. Mystery clients were trained and sent to randomly selected community pharmacies. Bivariate analysis using chi-square test was used to assess the association between different characteristics of the respondents and antibiotic use in children. Logistics regression was done to determine strengths of association between the variables. The findings were reported with a 95% confidence interval and with a level of statistical significance set at p<0.05 for all tests. Results: Findings suggest that 66.0% of pharmacy workers dispense antibiotics without prescription to parents/guardians in community pharmacies. Differences between professional categories and dispensing of antibiotics without a prescription were not statistically significant (p=0.863). The most common antibiotics used irrationally in the treatment of self-limiting conditions were amoxicillin clavulanic acid and amoxicillin which are penicillin antibiotics. However, knowledge of classification of drugs (p=0.007) according to the FDA‟s reviewed drug classification list and demand for antibiotics by parents/guardians (p= 0.013) showed a significant association with respect to whether a pharmacist will dispense antibiotics without a prescription to parents/guardians of children under five years. It was found out that about 39% of pharmacy workers in the mystery client survey who dispensed antibiotics without prescription to clients declined to dispensing antibiotics without prescription in the questionnaire. Conclusion: Dispensing antibiotics for the treatment of self-limiting conditions in children under five is a common practice by pharmacy workers in the community pharmacies. Lack of knowledge that antibiotics are not part of prescription only medications and the demand for antibiotics from parents/guardians are the driving forces for people dispensing antibiotics irrationally in children under five.