Prah James, Kizzie-Hayford Joseph, Walker Emmanuel, Ampofo-Asiama Adelaide
University of Cape Coast Hospital, University of Cape Coast, Ghana.
Pan Afr Med J. 2017 Nov 7;28:214. doi: 10.11604/pamj.2017.28.214.13940. eCollection 2017.
A major challenge to the provision of health care worldwide is the irrational use of antibiotics. To help promote rational use of drugs, standard treatment guidelines (STG) and essential medicine lists and facility-specific formularies have been developed to be used by clinicians. This study assessed the prescription pattern of antibiotics and explored the use of STG by clinicians.
A prospective cross sectional study that made use of seven core drug use indicators was conducted from February, 2017 to July, 2017. Prescribing indicators were assessed using 388 prescriptions that were submitted for filling and dispensing at the pharmacy unit of the hospital. Clinicians were interviewed to assess their use of STG. Data were analyzed using SPSS version 20.0 with a p-value of < 0.05 considered as statistically significant.
A total of 1351 drugs were prescribed for 388 patients. The average number of medicines per prescription was 3.5. Of the 388 prescriptions, 55.2% bore antibiotics, with amoxicillin (22.5%) and ciprofloxacin (18.4%) being the most prescribed antibiotics. Patients' knowledge about their medications was found to be significantly associated with the number of drugs per prescription (p = 0.001), age (p = 0.015) and educational level (p = 0.001). Only 41.7% of prescribers had copies of STG and used them.
The prescribing and dispensing practices in the hospital were generally not satisfactory with a low patronage of STG among prescribers. In order to improve the situation, clinicians should practice evidence based medicine rather than empirical treatment of conditions as well as use the STG in practice.
全球医疗保健面临的一项重大挑战是抗生素的不合理使用。为帮助促进合理用药，已制定了标准治疗指南（STG）、基本药物清单和针对特定机构的处方集供临床医生使用。本研究评估了抗生素的处方模式，并探讨了临床医生对STG的使用情况。
2017年2月至2017年7月进行了一项前瞻性横断面研究，该研究使用了七个核心药物使用指标。通过在医院药房提交用于配药和发药的388张处方来评估处方指标。对临床医生进行访谈以评估他们对STG的使用情况。使用SPSS 20.0软件进行数据分析，p值<0.05被认为具有统计学意义。
共为388名患者开出了1351种药物。每张处方的平均用药数量为3.5种。在388张处方中，55.2%含有抗生素，其中阿莫西林（22.5%）和环丙沙星（18.4%）是最常开具的抗生素。发现患者对其所用药物的了解与每张处方的用药数量（p = 0.001）、年龄（p = 0.015）和教育水平（p = 0.001）显著相关。只有41.7%的开处方者拥有STG副本并使用它们。
医院的处方和配药做法总体上不尽人意，开处方者对STG的使用率较低。为改善这种情况，临床医生应采用循证医学而非根据经验治疗病症，并在实践中使用STG。
