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

Hosp Pract (1995). 2017 Oct;45(4):143-149. doi: 10.1080/21548331.2017.1348139. Epub 2017 Jul 13.

Abstract

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, widely used 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 patient-record cards was assessed using a modified WHO drug-utilization evaluation criteria as well as referencing the national standard treatment guidelines in Ghana and the ceftriaxone package insert.

Results: A total of 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% (n = 218). The doses most prescribed were 1g (41%) and 2g (39%). 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% against a pre-set threshold of 97%.

Conclusion: The appropriateness of ceftriaxone prescribing was high in this leading hospital in Ghana; however, there is room for improvement with targeted education initiatives, with further research planned.

Keywords: Appropriateness; Ghana; ceftriaxone; drug use evaluation; thresholds.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / standards
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections / drug therapy*
  • Bacterial Infections / epidemiology
  • Ceftriaxone / administration & dosage*
  • Ceftriaxone / standards
  • Ceftriaxone / therapeutic use
  • Child
  • Child, Preschool
  • Coinfection / drug therapy
  • Cross-Sectional Studies
  • Drug Utilization Review*
  • Female
  • Ghana / epidemiology
  • Humans
  • Infant
  • Injections
  • Malaria / drug therapy*
  • Malaria / epidemiology
  • Male
  • Middle Aged
  • Pharmacy Service, Hospital / statistics & numerical data*
  • Pilot Projects
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Ceftriaxone