Exploring the Use of Antibiotics for Dental Patients in a Middle-Income Country: Interviews with Clinicians in Two Ghanaian Hospitals

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Exploring the Use of Antibiotics for Dental Patients in a Middle-Income Country: Interviews with Clinicians in Two Ghanaian Hospitals


JournalAntibiotics
Article typeJournal research article – Clinical research
Publication date – Aug – 2022
Authors – Jacqueline Sneddon, Wendy Thompson, Lily N. A. Kpobi, Diana Abena Ade, Israel Abebrese Sefah, Daniel Afriyie, Joanna Goldthorpe, Rebecca Turner, Saher Nawaz, Shona Wilson, Jo Hart, Lucie Byrne-Davis
Keywordsantimicrobial resistance, dental infection, prescribing
Open access – Yes
SpecialityMaxillofacial and oral surgery, Surgical infection
World region Western Africa
Country: Ghana
Language – English
Submitted to the One Surgery Index on August 24, 2022 at 5:19 am
Abstract:

Background: Antimicrobial resistance is a global problem driven by the overuse of antibiotics. Dentists are responsible for about 10% of antibiotics usage across healthcare worldwide. Factors influencing dental antibiotic prescribing are numerous, with some differences in low- and middle-income countries compared with high-income countries. This study aimed to explore the antibiotic prescribing behaviour and knowledge of teams treating dental patients in two Ghanaian hospitals. Methods: Qualitative interviews were undertaken with dentists, pharmacists, and other healthcare team members at two hospitals in urban and rural locations. Thematic and behaviour analyses using the Actor, Action, Context, Target, Time framework were undertaken. Results: Knowledge about ‘antimicrobial resistance and antibiotic stewardship’ and ‘people and places’ were identified themes. Influences on dental prescribing decisions related to the organisational context (such as the hierarchical influence of colleagues and availability of specific antibiotics in the hospital setting), clinical issues (such as therapeutic versus prophylactic indications and availability of sterile dental instruments), and patient issues such as hygiene in the home environment, delays in seeking professional help, ability to access antibiotics in the community without a prescription and patient’s ability to pay for the complete prescription. Conclusions: This work provides new evidence on behavioural factors influencing dental antibiotic prescribing, including resource constraints which affect the availability of certain antibiotics and diagnostic tests. Further research is required to fully understand their influence and inform the development of new approaches to optimising antibiotic use by dentists in Ghana and potentially other low- and middle-income countries.

OSI Number – 21724

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