Appropriateness of Antibiotic Prescribing for Acute Conjunctivitis: A Cross-Sectional Study at a Specialist Eye Hospital in Ghana, 2021

Abstract

Most presentations of conjunctivitis are acute. Studies show that uncomplicated cases resolve within 14 days without medication. However, antibiotic prescription remains standard practice. With antimicrobial resistance becoming a public health concern, we undertook this study to assess antibiotic prescription patterns in managing acute conjunctivitis in an eye hospital in Ghana. We recorded 3708 conjunctivitis cases; 201 were entered as acute conjunctivitis in the electronic medical records (January to December 2021). Of these, 44% were males, 56% were females, 39% were under 5 years, 21% were children and adolescents (5-17 years) and 40% were adults (≥18 years). A total of 111 (55.2%) patients received antibiotics, of which 71.2% were appropriately prescribed. The use of antibiotics was more frequent in children under 17 years compared to adults (p < 0.0001). Of the prescribed antibiotics, 44% belonged to the AWaRe "Access" category (Gentamycin, Tetracycline ointment), while 56% received antibiotics in the "Watch" category (Ciprofloxacin, Tobramycin). Although most of the antibiotic prescribing were appropriate, the preponderance of use of the Watch category warrants stewardship to encompass topical antibiotics. The rational use of topical antibiotics in managing acute conjunctivitis will help prevent antimicrobial resistance, ensure effective health care delivery, and contain costs for patients and the health system.

Keywords: AWaRe; Ghana; SORT IT; West Africa; acute conjunctivitis; antimicrobial resistance; eye care; operational research; topical antibiotics.

Figure 1

Antibiotic prescription pattern per WHO Access, Watch, Reserve (AWaRe) classification among patients presenting with acute conjunctivitis at a specialist eye hospital in Ghana from 1 January to 31 December 2021.

Figure 2

Number and proportion of patients who received a prescription of topical antibiotics.

Figure 3

Proportions of antibiotics prescribed per age group.