Antibiotic Use in Pediatric Care in Ghana: A Call to Action for Stewardship in This Population
Abstract
1. Introduction
2. Results
2.1. Patient Characteristics and Their Association with Guideline Compliance
2.2. Predictors of Level of Appropriateness Based on Treatment Guideline Compliance
3. Discussion
4. Materials and Methods
4.1. Study Design
4.2. Study Site and Population
4.3. Inclusion and Exclusion Criteria
4.4. Sample Size and Sampling Technique
4.5. Data Collection
4.6. Antibiotic Appropriateness
4.7. Data Analysis
4.8. Ethical Consideration
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Total, n (%) | Compliance with the Guideline | p-Value | |
---|---|---|---|---|
Age (years), mean ± SD | 2.39 ± 2.99 | Yes, n (%) | No, n (%) | |
Duration of admission (days), mean ± SD | 9.14 ± 10.73 | |||
Duration of antibiotics (days), mean ± SD | 3.03 ± 2.43 | |||
Age (years) (n = 319) | 0.393 | |||
0–2 | 219 (68.65) | 99 (45.21) | 120 (54.79) | |
3–5 | 53 (16.61) | 20 (37.74) | 33 (62.26) | |
6–8 | 26 (8.15) | 10 (38.46) | 16 (61.54) | |
9–11 | 21 (6.58) | 6 (28.57) | 15 (71.43) | |
Gender (n = 319) | 0.591 | |||
Male | 174 (54.55) | 76 (43.68) | 98 (56.32) | |
Female | 145 (45.45) | 59 (40.69) | 86 (59.31) | |
Residence (n = 318) | 0.836 | |||
Rural | 149 (46.86) | 62 (41.61) | 87 (58.39) | |
Urban | 144 (45.28) | 61 (42.36) | 83 (57.64) | |
Peri-urban | 25 (7.86) | 12 (48.00) | 13 (52.00) | |
Duration of admission (days) (n = 319) | 0.569 | |||
1–5 | 153 (47.96) | 69 (45.10) | 84 (54.90) | |
5–10 | 87 (27.27) | 36 (41.38) | 51 (58.62) | |
>10 | 79 (24.76) | 30 (37.97) | 49 (62.03) | |
Treatment based on biomarker (n = 319) | 0.304 | |||
Yes | 308 (96.55) | 132 (42.86) | 176 (57.14) | |
No | 11 (3.45) | 3 (27.27) | 8 (72.72) | |
If yes, (n = 308) | 0.262 | |||
WBC | 128 (41.56) | 49 (38.28) | 79 (61.72) | |
WBC + CRP | 81 (26.30) | 38 (46.91) | 43 (53.09) | |
WBC + urine R/E | 58 (18.83) | 25 (43.10) | 33 (56.90) | |
WBC + CRP + urine R/E | 20 (6.49) | 7 (35.00) | 13 (65.00) | |
Other | 21 (6.82) | 13 (61.90) | 8 (38.10) | |
Number of antibiotics (n = 319) | 0.546 | |||
1 | 120 (37.62) | 46 (38.33) | 74 (61.67) | |
2 | 181 (56.74) | 83 (45.86) | 98 (54.14) | |
3 | 15 (4.71) | 5 (33.33) | 10 (66.67) | |
4 | 3 (0.93) | 1 (33.33) | 2 (66.67) | |
Antibiotic type (n = 319) | <0.001 * | |||
Ceftriaxone | 66 (20.69) | 24 (36.36) | 42 (63.64) | |
Cefotaxime + flucloxacillin | 51 (15.99) | 0 (0.00) | 51 (100.00) | |
Ampicillin + gentamicin | 48 (15.05) | 48 (100.00) | 0 (0.00) | |
Amoxicillin + clavulanic acid | 24 (7.52) | 10 (41.67) | 14 (58.33) | |
Ceftriaxone + metronidazole | 21 (6.58) | 9 (42.86) | 12 (57.14) | |
Other ^ | 109 (34.17) | 44 (40.37) | 65 (59.63) | |
WHO AWaRe * category (n = 317) | <0.001 * | |||
Access | 86 (27.13) | 63 (73.26) | 23 (26.74) | |
Watch | 95 (29.97) | 40 (42.10) | 55 (57.89) | |
Access + Watch | 136 (42.90) | 32 (23.53) | 104 (76.47) | |
Route of administration (n = 319) | 0.009 * | |||
Intravenous | 264 (82.76) | 108 (40.91) | 156 (59.09) | |
Oral | 15 (4.70) | 6 (40.00) | 9 (60.00) | |
Topical | 5 (1.57) | 0 (0) | 5 (100.00) | |
Intravenous + oral | 27 (8.46) | 19 (70.37) | 8 (29.63) | |
Other | 8 (2.51) | 2 (25.00) | 6 (75.00) | |
Diagnosis (n = 319) | <0.001 * | |||
Neonatal sepsis | 77 (24.14) | 33 (42.86) | 44 (57.14) | |
Neonatal jaundice due to sepsis | 18 (5.64) | 11 (61.11) | 7 (38.89) | |
Pneumonia | 46 (14.42) | 39 (84.78) | 7 (15.22) | |
Surgical wound prophylaxis | 46 (14.42) | 2 (4.35) | 44 (95.65) | |
Tonsillitis | 17 (5.33) | 11 (64.71) | 6 (35.29) | |
Other # | 115 (36.05) | 44 (38.26) | 71 (61.74) |
Variable | aOR | 95% CI | p-Value |
---|---|---|---|
Antibiotic name | |||
Amoxicillin + clavulanic acid (R) | 1.00 | ||
Ceftriaxone | 0.12 | 0.02–0.95 | 0.044 * |
Cefotaxime + flucloxacillin | 1.00 | ||
Ampicillin + gentamicin | 1.00 | ||
Ceftriaxone + metronidazole | 0.38 | 0.05–3.09 | 0.368 |
Other | 0.35 | 0.07–1.86 | 0.220 |
WHO AWaRe category | |||
Access (R) | 1.00 | ||
Watch | 1.28 | 0.27–5.97 | 0.757 |
Access + Watch | 4.86 | 0.12–1.95 | 0.309 |
Route of administration | |||
Intravenous (R) | 1.00 | ||
Oral | 0.54 | 0.14–2.03 | 0.361 |
Topical | 1.00 | ||
Intravenous + oral | 1.26 | 0.38–4.16 | 0.703 |
Other | 0.38 | 0.05–2.61 | 0.322 |
Diagnosis | |||
Neonatal sepsis (R) | 1.00 | ||
Neonatal jaundice due to sepsis | 1.00 | ||
Pneumonia | 15.38 | 3.30–71.62 | <0.001 * |
Surgical wound prophylaxis | 0.07 | 0.01–0.42 | 0.004 * |
Tonsillitis | 1.00 | ||
Other | 1.80 | 0.50–6.53 | 0.371 |
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Sefah, I.A.; Bosrotsi, D.K.; Buabeng, K.O.; Godman, B.; Bangalee, V. Antibiotic Use in Pediatric Care in Ghana: A Call to Action for Stewardship in This Population. Antibiotics 2025, 14, 779. https://doi.org/10.3390/antibiotics14080779
Sefah IA, Bosrotsi DK, Buabeng KO, Godman B, Bangalee V. Antibiotic Use in Pediatric Care in Ghana: A Call to Action for Stewardship in This Population. Antibiotics. 2025; 14(8):779. https://doi.org/10.3390/antibiotics14080779
Chicago/Turabian StyleSefah, Israel Abebrese, Dennis Komla Bosrotsi, Kwame Ohene Buabeng, Brian Godman, and Varsha Bangalee. 2025. "Antibiotic Use in Pediatric Care in Ghana: A Call to Action for Stewardship in This Population" Antibiotics 14, no. 8: 779. https://doi.org/10.3390/antibiotics14080779
APA StyleSefah, I. A., Bosrotsi, D. K., Buabeng, K. O., Godman, B., & Bangalee, V. (2025). Antibiotic Use in Pediatric Care in Ghana: A Call to Action for Stewardship in This Population. Antibiotics, 14(8), 779. https://doi.org/10.3390/antibiotics14080779