CoChat
Sign Up
Cited by 85Antibiotic Use and ResistancePharmaceutical Practices and Patient OutcomesHealthcare cost, quality, practices

A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana

Open access
Ahiabu, Mary-Anne, Tersbøl, Britt P, Biritwum, Richard, Bygbjerg, Ib C, Magnussen, Pascal·2016·Health Policy and Planning
DOI 10.1093/heapol/czv048PMC PMC4748131
Open this paper in CoChat — free accountOpen PDF

Abstract

Resistance to antibiotics is increasing globally and is a threat to public health. Research has demonstrated a correlation between antibiotic use and resistance development. Developing countries are the most affected by resistance because of high infectious disease burden, limited access to quality assured antibiotics and more optimal drugs and poor antibiotic use practices. The appropriate use of antibiotics to slow the pace of resistance development is crucial. The study retrospectively assessed antibiotic prescription practices in four public and private primary health-care facilities in Eastern Region, Ghana using the WHO/International Network for the Rational Use of Drugs rational drug use indicators. Using a systematic sampling procedure, 400 prescriptions were selected per facility for the period April 2010 to March 2011. Rational drug use indicators were assessed in the descriptive analysis and logistic regression was used to explore for predictors of antibiotic prescription. Average number of medicines prescribed per encounter was 4.01, and 59.9% of prescriptions had antibiotics whilst 24.2% had injections. In total, 79.2% and 88.1% of prescribed medicines were generics and from the national essential medicine list, respectively. In the multivariate analysis, health facility type (odds ratio [OR] = 2.05; 95% confidence interval [CI]: 1.42, 2.95), patient age (OR = 0.97; 95% CI: 0.97, 0.98), number of medicines on a prescription (OR = 1.85; 95% CI: 1.63, 2.10) and 'no malaria drug' on prescription (OR = 5.05; 95% CI: 2.08, 12.25) were associated with an antibiotic prescription. A diagnosis of upper respiratory tract infection was positively associated with antibiotic use. The level of antibiotic use varied depending on the health facility type and was generally high compared with the national average estimated in 2008. Interventions that reduce diagnostic uncertainty in illness management should be considered. The National Health Insurance Scheme, as the main purchaser of health services in Ghana, offers an opportunity that should be exploited to introduce policies in support of rational drug use.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1093/heapol/czv048

Cites

52 of 52 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Most high-income countries have adopted guidelines for the rational use of antibiotics, but more efforts are needed in lower-middle-income countries.

    “While most high-income countries have adopted guidelines for the rational use of antibiotics, more efforts are needed in lower-middle-income countries [9,10,11].”

    From A Systematic Review on Antimicrobial Resistance in Ghana from a One Health Perspective (2024) · cites this paper as [9]

    The Conclusion (page unavailable) calls for interventions to promote rational antibiotic use in Ghana, supporting the need for more effort there. The Introduction (page unavailable) says Ghana has therapeutic guidelines, but the paper does not establish that most high-income countries have adopted such guidelines or extend its recommendation specifically to all lower-middle-income countries. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Machin D Campbell MJ Walters SJ 2007 Medical Statistics. 4th edn West Sussex, England: Wiley, 118– 79.

Cited by

Sorted by citations

Related

Authors
Ahiabu, M.-A., Tersbøl, B. P., Biritwum, R., Bygbjerg, I. C., & Magnussen, P.
Affiliations
  • Ministry of Health (GH)
  • University of Copenhagen (DK)
  • University of Ghana (GH)
Corresponding author
Ahiabu, Mary-Anne
ORCID
Venue
Health Policy and Planning
Publisher
Oxford University Press (OUP)
Published
2015-06-04
Volume
31
Issue
2
Pages
250-258
ISSN
  • 0268-1080 (ISSN-L)
  • 1460-2237
DOI
10.1093/heapol/czv048
PMC
PMC4748131
OpenAlex
W1896658919
Cited by
85
References
52
Citations by year
2026: 5 · 2025: 8 · 2024: 6 · 2023: 8 · 2022: 11 · 2021: 13 · 2020: 9 · 2019: 6 · 2018: 9 · 2017: 7 · 2016: 2 · 2015: 1
FWCI
5.73
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Health Policy and Planning (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by)
  • HighWire Press Open Archive (submittedVersion)
Funders
  • Udenrigsministeriet
  • University of Ghana
  • Danish International Development Agency
Topics
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
  • Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
Keywords
antibiotic prescribing, antibiotic resistance, rational drug use, primary care, health facility type, malaria treatment, upper respiratory tract infection, diagnostic uncertainty, National Health Insurance Scheme, Eastern Region of Ghana
MeSH terms
Adolescent, Adult, Aged, Anti-Bacterial Agents, Child, Child, Preschool, Developing Countries, Drug Resistance, Microbial, Female, Ghana, Health Facilities, Humans, Male, Middle Aged, Practice Patterns, Physicians', Primary Health Care, Retrospective Studies, Drug Utilization Review, Drugs, Essential, Prescription Drugs, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review