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Implementation of a delayed prescribing model to reduce antibiotic prescribing for suspected upper respiratory tract infections in a hospital outpatient department, Ghana

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Ghebrehewet, Sam, Shepherd, Wendi, Panford-Quainoo, Edwin, Shantikumar, Saran, Decraene, Valerie, Rajendran, Rajesh, Kaushal, Menaal, Akuffo, Afua, Ayerh, Dinah and Amofah, George (2020) Implementation of a delayed prescribing model to reduce antibiotic prescribing for suspected upper respiratory tract infections in a hospital outpatient department, Ghana. Antibiotics, 9 (11). 773. doi:10.3390/antibiotics9110773

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Official URL: https://doi.org/10.3390/antibiotics9110773

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Abstract

Background: High levels of antimicrobial resistance (AMR) in Ghana require the exploration of new approaches to optimise antimicrobial prescribing. This study aims to establish the feasibility of implementation of different delayed/back-up prescribing models on antimicrobial prescribing for upper respiratory tract infections (URTIs).

Methods: This study was part of a quality improvement project at LEKMA Hospital, Ghana, (Dec 2019–Feb 2020). Patients meeting inclusion criteria were assigned to one of four groups (Group 0: No prescription given; Group 1; Patient received post-dated antibiotic prescription; Group 2: Offer of a rapid reassessment of patient by a nurse practitioner after 3 days; and Group 3: Post-dated prescription forwarded to hospital pharmacy). Patients were contacted 10 days afterwards to ascertain wellbeing and actions taken, and patients were asked rate the service on a Likert scale. Post-study informal discussions were conducted with hospital staff. Results: In total, 142 patients met inclusion criteria. Groups 0, 1, 2 and 3 had 61, 16, 44 and 21 patients, respectively. Common diagnosis was sore throat (73%). Only one patient took antibiotics after 3 days. Nearly all (141/142) patients were successfully contacted on day 10, and of these, 102 (72%) rated their experiences as good or very good. Informal discussions with staff revealed improved knowledge of AMR.

Conclusions: Delayed/back-up prescribing can reduce antibiotic consumption amongst outpatient department patients with suspected URTIs. Delayed/back-up prescribing can be implemented safely in low and middle-income countries (LMICs).

Item Type: Journal Article
Subjects: Q Science > QR Microbiology
R Medicine > RC Internal medicine
R Medicine > RM Therapeutics. Pharmacology
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET)
Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Drugs -- Prescribing -- Ghana, Respiratory infections -- Treatment -- Ghana, Drug resistance in microorganisms -- Ghana, Antibiotics
Journal or Publication Title: Antibiotics
Publisher: M.D.P.I.AG
ISSN: 2079-6382
Official Date: 4 November 2020
Dates:
DateEvent
4 November 2020Published
31 October 2020Accepted
Volume: 9
Number: 11
Article Number: 773
DOI: 10.3390/antibiotics9110773
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIEDDepartment of Health, Social Services and Public Safetyhttp://dx.doi.org/10.13039/501100000688

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