Antibiotic Stewardship and Its Impact on Antibiotic Use at The Child Health Directorate of A Teaching Hospital In Ghana
DOI:
https://doi.org/10.26437/ajar.31.10.2022.22Abstract
Purpose: The study was intended to ascertain the existence of an antibiotic stewardship programme at the Child Health Directorate of Komfo Anokye Teaching Hospital (KATH) and assess the knowledge of health professionals about the importance of the antimicrobial stewardship programme. Again, it sort to assess the experience of participants with pharmacotherapy of infections and patient outcomes with generic and innovative brands of antibiotics. The third was to assess reporting on adverse reactions and storage conditions of the antibiotics.
Design/Methodology/ Approach: This was a cross-sectional study involving health professionals who participated in the provision of infectious disease management services.
Findings: Eighty-eight (88) professionals were involved in the study, comprising nurses (n=51), medical doctors (n=21), pharmacists (n=8), biomedical scientists (n=5) and public health officers (n=3). No antibiotic stewardship programme existed. However, there was a protocol for antibiotic use that was not strictly adhered to. About 60 % of the participants had knowledge of the antibiotic stewardship programme and affirmed its importance. The majority (75 %, n=66) reported treatment failure with generic brands of antibiotics compared to innovator brands. Thirty-four percent of the participants (n=30) reported adverse drug reactions (ADRs) on antibiotic therapy to superiors instead of filling out ADR forms. Antibiotics were kept in inpatient bedside cabinets with no thermometers to monitor the storage temperature conditions.
Research Limitations: The study was done in one Directorate in the hospital and thus cannot be generalized to reflect the situation in all teaching hospitals in Ghana.
Practical implication: The evidence obtained highlighted the need for pragmatic antimicrobial stewardship (AMS) at the directorate to help optimize the management of childhood infections and minimize the emergence and spread of antibiotic resistance.
Originality/Value. This was an original project designed to generate evidence to inform interventions to promote the responsible use of antimicrobials in children.
References
Asante, K. P., Boamah, E. A., Abdulai, M. A., Buabeng, K. O., Mahama, E., Dzabeng, F., ... &
Gyansa-Lutterodt, M. (2017). Knowledge of antibiotic resistance and antibiotic prescription practices among prescribers in the Brong Ahafo Region of Ghana; a cross-sectional study. BMC health services research, 17(1), 1-9.
Ayukekbong, J. A., Ntemgwa, M., & Atabe, A. N. (2017). The threat of antimicrobial resistance
in developing countries: causes and control strategies. Antimicrobial Resistance & Infection Control, 6(1), 1-8.
Bernabe, K. J., Langendorf, C., Ford, N., Ronat, J. B., & Murphy, R. A. (2017). Antimicrobial
resistance in West Africa: a systematic review and meta-analysis. International journal of antimicrobial agents, 50(5), 629-639.
Berkley, J. A., Maitland, K., Mwangi, I., Ngetsa, C., Mwarumba, S., Lowe, B. S., ... & English,
M. (2005). Use of clinical syndromes to target antibiotic prescribing in seriously ill children in malaria endemic area: observational study. Bmj, 330(7498), 995.
Centre for disease control and prevention (2017).Core elements of hospital antibiotic stewardship
programmes.
Cliff-Eribo, K. O., Choonara, I., Dodoo, A., Darko, D. M., & Sammons, H. (2015). Adverse drug
reactions in Ghanaian children: Review of reports from 2000 to 2012 in VigiBase. Expert opinion on drug safety, 14(12), 1827-1833.
Del Tacca, M., Pasqualetti, G., Di Paolo, A., Virdis, A., Massimetti, G., Gori, G., ... & Blandizzi,
C. (2009). Lack of pharmacokinetic bioequivalence between generic and branded amoxicillin formulations. A post‐marketing clinical study on healthy volunteers. British journal of clinical pharmacology, 68(1), 34-42.
Edwards, I. R., & Aronson, J. K. (2000). Adverse drug reactions: definitions, diagnosis, and
management. The lancet, 356(9237), 1255-1259.
Gil, I., Font, I., Bernabé, J., Edo, M., Bosó, V., & Poveda, J. L. (2012). Design of the medicines
storage area in hospital wards. European Journal of Hospital Pharmacy: Science and Practice, 19(2), 165-165.
Gyansa-Lutterodt, M. (2013). Antibiotic resistance in Ghana. The Lancet. Infectious diseases,
(12), 1006-1007.
Howard, P., Pulcini, C., Levy Hara, G., West, R. M., Gould, I. M., Harbarth, S., & Nathwani, D.
(2015). An international cross-sectional survey of antimicrobial stewardship programmes in hospitals. Journal of Antimicrobial Chemotherapy, 70(4), 1245-1255.
Leekha, S., Terrell, C.L., & Edson, R.S. (2010.General Principles of Antimicrobial Therapy. Mayo
Clinic Proceedings 86(2);156-167.
Lerbech, A. M., Opintan, J. A., Bekoe, S. O., Ahiabu, M. A., Tersbøl, B. P., Hansen, M., ... &
Styrishave, B. (2014). Antibiotic exposure in a low-income country: screening urine samples for presence of antibiotics and antibiotic resistance in coagulase negative staphylococcal contaminants. PloS one, 9(12), e113055.
Mayer, M. H., Dowsett, S. A., Brahmavar, K., Hornbuckle, K., & Brookfield, W. P. (2010).
Reporting adverse drug events. US Pharmacist, 35(4).
Pulcini, C., Williams, F., Molinari, N., Davey, P., & Nathwani, D. (2011). Junior doctors'
knowledge and perceptions of antibiotic resistance and prescribing: a survey in France and Scotland. Clinical microbiology and infection, 17(1), 80-87.
Reardon, S. (2015). Dramatic rise seen in antibiotic use. Nature.
Rodriguez, C.A., Agudelo, M., Aguilar,Y.A., Zuluaga, A.F., & Vesga, O. (2016).Impact on
Bacterial Resistance of Therapeutically Nonequivalent Generics: The Case of Piperacillin-Tazobactam.Plos One journal 11(5):0155806.
Sabblah, G. T., Akweongo, P., Darko, D., Dodoo, A. N. O., & Sulley, A. M. (2014). Adverse
drug reaction reporting by doctors in a developing country: a case study from Ghana. Ghana medical journal, 48(4), 189-193.
Tadesse, B. T., Ashley, E. A., Ongarello, S., Havumaki, J., Wijegoonewardena, M., González, I.
J., & Dittrich, S. (2017). Antimicrobial resistance in Africa: a systematic review. BMC infectious diseases, 17(1), 1-17.
Truter, A., Schellack, N., & Meyer, J. C. (2017). Identifying medication errors in the neonatal
intensive care unit and paediatric wards using a medication error checklist at a tertiary academic hospital in Gauteng, South Africa. South African Journal of Child Health, 11(1), 5-10.
Vesga, O., Maria Agudelo, M., Salazar, B.E., Rodriguez, C.A., & Zuluaga, A. F. (2010).Generic
Vancomycin Products Fail In Vivo despite Being Pharmaceutical Equivalents of the Innovator. Antimicrobial agents and chemotherapy 54(8):3271-3279.
WHO (2003). Guidelines for the storage of essential medicines and other health commodities.
York, P.(1977). The shelf life of some antibiotic preparations stored under tropical
conditions.Europe PMC journal 32(2):101-104.
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2022 AFRICAN JOURNAL OF APPLIED RESEARCH
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
By submitting and publishing your articles in the African Journal of Applied Research, you agree to transfer the copyright of the Article from the authors to the Journal ( African Journal of Applied Research).
