A pilot study evaluating the prescribing of ceftriaxone in hospitals in Ghana : findings and implications

Afriyie, Daniel Kwame and Amponsah, Seth Kwabena and Dogbey, Justice and Agyekum, Kwabena and Kesse, Samuel and Truter, Ilse and Meyer, Joanna C and Godman, Brian (2017) A pilot study evaluating the prescribing of ceftriaxone in hospitals in Ghana : findings and implications. Hospital Practice, 45 (4). pp. 143-149. ISSN 2377-1003 (https://doi.org/10.1080/21548331.2017.1348139)

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Background and Objectives: Widespread empiric use of antibiotics exists especially in developing countries. This is a concern since inappropriate use of antibiotics, including their extended inappropriate use, will increase resistance rates. Consequently, there is a need to evaluate antibiotic utilisation across healthcare sectors to improve future use. This includes ceftriaxone in hospitals as it is a widely used antibiotic among hospitals including those in Ghana. Methods: A cross-sectional study to evaluate the appropriateness of ceftriaxone prescribing in a leading hospital in Ghana. Ceftriaxone prescribing in the patient record cards was assessed using modified WHO drug utilization evaluation criteria as well as referencing the national standard treatment guidelines in Ghana and the ceftriaxone package insert. Results: 251 patients were assessed. Ceftriaxone was most commonly prescribed for comorbid malaria with bacterial infections, urinary tract infections, sepsis and gastroenteritis. The appropriateness of the indication was 86.9% (n = 218). The doses most prescribed were 1 g (41.4%) and 2 g (39.4%). Stat dose and once daily dosage regimen constituted 51.4% and 84.5% respectively. The most common duration of treatment was 1 (51.4%) and 2 days (35.1%). The overall appropriateness of prescribing was 93.0% against a pre-set threshold of 97.9%. Conclusion: The appropriateness of ceftriaxone prescribing was high in this leading hospital in Ghana. However, there is room for improvement with targeted educational initiatives, with further research planned.