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Background: 1 in 10 of all antibiotic prescriptions globally are for dental conditions with 80% of them being inappropriate making it a potential source of antimicrobial resistance. The study aims to evaluate antibiotic use among ambulatory patients seeking dental care services in a Public Hospital in Ghana. Methods: A retrospective clinical audit was conducted by extracting the medical records of all patients seeking dental primary care at the ambulatory care clinic of Keta Municipal Hospital (KMH) from January 2020 to December 2020 using the hospital’s electronic database. Descriptive statistics, bivariate and multivariate analysis were performed on the data collected. Results:1433 patient medical records were extracted from the hospital electronic data within the study period. The mean age of the patients identified was 39 years with almost two thirds being female. Over 90% of them were attended to by a dental nurse. 88.6% of the patients received antibiotics and 87.5% of antibiotics prescribed were non-compliant with Ghana Standard Treatment Guidelines. Again, three-quarters of the dental conditions were managed with dual antibiotics comprising of amoxicillin and metronidazole. Antibiotic prescription was associated with the age, gender, the type of prescriber and the type of dental condition diagnosed. Conclusion: There is a high usage of antibiotics for dental conditions managed at the outpatient section of the hospital. Development of local guidelines supported by education of dental clinician especially dental nurses on empiric selection of antibiotics for common dental conditions is a suitable target for AMS team to address in KMH.

Objective: Diabetes mellitus is a growing public health problem in many countries including Ghana. Adherence to drugs, especially among patients with type 2 diabetes mellitus (T2DM) is often poor is some resource-poor settings. The objective of this study was to assess adherence to oral hypoglycemic drugs and factors that affect adherence among patients with T2DM in the Volta Region of Ghana. Methods: The study was cross-sectional and conducted among 400 patients with T2DM attending diabetic clinics at 4 randomly selected hospitals in the Volta Region of Ghana between January 10 and March 30, 2015. Patients were interviewed using a structured questionnaire and other data collection tools to determine the commonest self-reported reason(s) for nonadherence. Adherence was assessed using the 8-item Morisky Medication Adherence Scale. Multivariate analysis was performed between adherence and statistically significant patient variables. Results: Adherence to oral hypoglycemic drugs among T2DM patients was 47.75%. The odds of adherence with fasting blood glucose between 1 and 6 mmol/L was approximately two-fold (adjusted odd ratio [aOR] =1.92, confidence interval [CI]: 1.11–3.32) versus the odds of having fasting blood glucose of above 10 mmol/L. The odds of adherence among patients with tertiary education was approximately three-fold (aOR = 3.01 CI: 1.44–6.269) versus patients with no formal education. The commonest self-reported reason for nonadherence was forgetfulness. Conclusion: Adherence to oral hypoglycemic drugs among T2DM patients in the current study was sub-optimal. Therefore, in such settings, management of T2DM must include strategies to identify nonadherent patients, and regular patient education and counseling.

Introduction and aims: Considerable differences in prevalence and mortality rates from COVID-19, with higher rates among European countries and Iran versus African and Asian countries in part due to early and extensive prevention measures. There has been considerable controversy surrounding hydroxychloroquine, with resultant misinformation increasing prices and suicides. Growing concerns also with unintended consequences of lockdown and other measures. Consequently, a need to investigate changes in utilisation and prices of relevant medicines during the pandemic in Namibia with its proactive approach to guide future decision making. Community pharmacists play a key role in this respect. Methods: Questionnaire survey among 55 pharmacists from March to end June 2020. Results: Proactivity among some pharmacists to plan for the pandemic with increased stocks. Limited increases in utilisation of antimalarials and antibiotics in Namibia versus other countries enhanced by restrictions on self-purchasing in Namibia, reflected in limited price rises and shortages. Higher use of Vitamin C/ immune boosters in Ghana and Nigeria versus Namibia reflected in higher price rises, with increased utilisation and prices of PPE across all countries. Encouragingly lower increases in herbal medicines in Namibia versus Ghana. Concerns though with unintended consequences. Conclusion: Encouraging to see continued low prevalence and mortality rates from COVID-19 in Namibia and limited increase in utilisation of antimalarials and antibiotics with prescribing restrictions. Concerns with rising rates of malaria and other infectious diseases following lockdown need addressing. Pharmacists can help plan for the future, educate the public during pandemics, help with vaccinations and general medicines management.

Objective Most evidence of adverse drug events (ADEs) come from hospitals as the risks associated with hospital care are higher. However, under-reporting of ADEs is a critical problem in all health care settings. This is important in Sub-Saharan African countries like Ghana with limited resources and high prevalence of both infectious and non-infectious diseases. Consequently, this study sought to determine the annual prevalence of spontaneously reported ADEs using six years reports and factors associated with the occurrence of serious ADE among outpatient care settings in Ghana to provide future guidance. Method A cross-sectional study was conducted using duplicates of Ghana Food and Drugs Authority adverse event forms retrieved from 3 outpatient care setting who had submitted their reports to the National Pharmacovigilance Centre in Ghana between 2013 and 2018. The raw data were entered into Microsoft excel and analyzed using stata version 14. Bivariate analyses were performed using Pearson chi square and all variables that were statistically significant were used for a multivariate analysis. Results Overall, 93 spontaneously reported cases of ADEs were identified during the study period. The mean age of the patients with a reported ADE was 42 ± 17 years, the annual prevalence rate was 192 reports per 1,000,000 population among our study population and the rate of serious ADE was 35.48% (95% CI: 25.83%-46.09%). Serious ADEs were associated with the type of indication for which the drug was prescribed (p=0.048), the duration of ADEs (p=0.047) and the decision to administer treatment at the reporting facility (p=0.017) and was independently predicted by duration of ADEs (aOR =7.63, 1.37-42.65) and decision to administer treatment for ADEs (aOR=20.28, 2.38-172.57). Conclusion Early reporting of ADEs at outpatient settings is essential. Patient education and awareness of potential ADE must be intensified for early identification and we will be following this up

The World Health Organisation (WHO) and others have identified, as a priority, the need to improve antimicrobial stewardship (AMS) interventions as part of the effort to tackle antimicrobial resistance (AMR). An international health partnership model, the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme, was established between selected countries in Africa (Ghana, Tanzania, Zambia and Uganda) and the UK to support AMS. This was funded by UK aid under the Fleming Fund and managed by the Commonwealth Pharmacists Association (CPA) and Tropical Health and Education Trust (THET). The primary aims were to develop local AMS teams and generate antimicrobial consumption surveillance data, quality improvement initiatives, infection prevention and control (IPC) and education/training to reduce AMR. Education and training were key components in achieving this, with pharmacists taking a lead role in developing and leading AMS interventions. Pharmacist-led interventions in Ghana improved access to national antimicrobial prescribing guidelines via the CwPAMS mobile app and improved compliance with policy from 18% to 70% initially for patients with pneumonia in one outpatient clinic. Capacity development on AMS and IPC were achieved in both Tanzania and Zambia, and a train-the-trainer model on the local production of alcohol hand rub in Uganda and Zambia. The model of pharmacy health partnerships has been identified as a model with great potential to be used in other low and middle income countries (LMICs) to support tackling AMR.