A research team from the Kwame Nkrumah University of Science and Technology (KNUST), Kumasi has successfully demonstrated that responsible prescribing practices can significantly reduce the misuse of antibiotics in Ghana.

Working with the University Hospital, the team implemented an antimicrobial stewardship programme to improve how medicines are prescribed at the Outpatient Department (OPD).

With the large proportion of OPD attendance and potential for widespread antimicrobial use, AMS interventions are needed in outpatient settings to impact prescribing and mitigate the spread of its resistance.

Antimicrobial Stewardship (AMS) is a set of coordinated initiatives and programs to ensure the appropriate and effective use of antimicrobial medications, including antibiotics, to achieve the best clinical outcomes, minimize patient harm, and slow the development of its resistance.

Using WHO guidelines and AMS, the researchers checked how often patients were given antibiotics, how many antibiotics were prescribed in total, and how often injections were used in the district hospital. Within two years, the intervention reduced the number of patients receiving antibiotics by half, from 36% in 2021 to 18% in 2023.

“The antimicrobial stewardship committee of the university health services was established in 2021 and it was one of the interventions that came up as a result of the growing health threats of antimicrobial resistance in Ghana and even globally. It is actually one of the top 10 global health threats and with our institution, it was set up so that we could mitigate the use or the misuse or the mischaracterisation of antibiotic in terms of patient care. And with their university's response to patient centred care and then also being able to train world health professionals, it is just a right step in the right direction,” said Dr. Nana Akua Abruquah, Lead Researcher and Medical Officer at the University Hospital.

The study, published in Tropical Medicine and Infectious Disease Journal, also revealed other positive changes, including a reduction in the average number of medicines prescribed per patient, greater use of generic medicines, and fewer injections being given.

These improvements align with World Health Organization (WHO) standards for safe and effective prescribing.

The researchers also suggest an exploration to identify enablers and barriers to the rational use of antibiotics at the hospital and to further guide the scale-up and sustainability of the interventions.

The researchers stress that antimicrobial resistance remains a global health threat but highlighted the results as proof that with the right interventions, hospitals in Ghana can protect patients and set higher standards in medical practice.

“It has improved use in our hospital and we would want to encourage other district hospitals, and other facilities in our district that it would be nice if we are able to bring about these interventions in other districts as well. I think it would be something unique for the districts around us,” said Dr. Abruquah.