Assessment of the knowledge and usage of oral pediatric antibiotics and antimalarials in Ho municipality

Abstract

Oral pediatric antibiotics and antimalarials are usually formulated as powders that must be correctly reconstituted and administered for effective therapy. We conducted this study, first of its kind in Ghana, to assess the knowledge and practices of caregivers/parents regarding reconstitution, storage, and administration of these products at Ho Teaching Hospital. Participants (N = 78) completed a semi-structured questionnaire, after which their reconstitution and dose measurement skills were evaluated by having them mix provided powders with water and measure 5 mL of the resulting mixture. Most participants knew of antibiotics (78.2 %) and antimalarials (59.0 %); however, 25.6 % of them never read reconstitution directions, and among those who read, only 55.2 % understand them. Additionally, majority seek advice on unclear directions from nurses (52.6 %), use overdiluted medications (70.5 %), shake reconstituted drugs before use (89.7 %), and read storage instructions (61.5 %). Reconstitution challenges listed by participants included uneven mixing, adding the required volume of diluent to reach a level mark, and powder clumping. Sachet (51.3 %), bottled (30.8 %), and tap (7.7 %) water were the main diluents indicated. Dosing times were incorrectly estimated by some respondents (21.8 %). Measuring cup (75.6 %) and medicine cabinet (55.1 %) were the most common dosing device and storage place for the medicines, respectively. Most respondents fully dispersed the given powder in water (97.4 %) and accurately measured 5 mL of their mixtures (82.0 %). Our findings indicate good caregiver knowledge of oral pediatric antimalarials and antibiotics. Educational background significantly influenced reconstitution skills and the reading and understanding of reconstitution and storage instructions, highlighting the need to use pharmacist-led teach-back methods during dispensing to ensure proper information uptake. Manufacturers must also use excipients with good reconstitution properties in such products and indicate instructions in caregiver-friendly language.