Pattern of antibacterial use: a case study of the surgical and medical emergency unit of Korle Bu Teaching Hospital, Accra, Ghana.

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Date
2009-08-14
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Abstract
The use of antimicrobials has contributed to the dramatic fall in morbidity from communicable and infectious diseases over the last 50 years globally, as to increasingly high levels of expenditure on and consumption of antimicrobials. A substantial proportion of the total drug budget in many countries is dedicated to antibiotics and they are often the largest single group of drugs purchased in developing countries. In developing countries like Ghana, relatively high levels of availability and consumption have led to disproportionately higher incidence of inappropriate use and greater levels of resistance compared to developed countries. This study tends to look at the pattern of antibacterial use in Surgical and Medical Emergency Unit of the Korlebu Teaching Hospital to serve as a baseline for further work. The unit where the work is taking place is the last referred point for the southern part of Ghana for most non-trauma emergencies. The work was to determine whether antibiotics are used in response to microbiological tests and also whether prescriptions conform to acceptable standards. A prospective study of patients admitted at the three wards of the Surgical and Medical Emergency Unit was undertaken from 14th January 2009 to 14th March 2009. Data Collection Sheets were used to collect data from patients’ medical records while on admission over the period. Patients’ records were reviewed once daily for 5 days until they were transferred to other units, discharged or died. The main findings are: 1. Only 39 (39%) Prescribers requested for Culture and Sensitivity test during the period. 2. Of the number that requested Culture and Sensitivity test, only 2 (5.1 %) had their results before antibacterial therapy was initiated. 3. 62.4% (63) of the patients received more than one antibacterial drug during the period. 4. The highest frequently used antibacterial was ciprofloxacin 48 (23.3%) followed closely by metronidazole 46 (22.3%) and then by Co-Amoksiclav 40 (19.4%). 5. 83.7% (164) of the used drugs were generic with 16.3% (32) branded. 6. 54.4% of drugs were administered through the parenteral route, 45% through the oral route and 0.6% by the topical route. Ciprofloxacin was the highest used drug and many of its prescriptions were for ‘blind’ therapy. Culture and sensitivity test results were hardly used in the selection of antibacterial therapies. The study therefore concluded that antibacterials were mostly used without basis for their choices.
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A Thesis submitted to the Department of Clinical and Social Pharmacy, Kwame Nkrumah University of Science and Technology in partial fulfilment of the requirements for the degree of Master of Science.
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