Abstract
BackgroundInappropriate antibiotic use is an important driver of antibiotic resistance. This study sought to explore inappropriate antibiotic use and confusing antibiotics with other medicines in Ghana using ethnomethodology research approach.MethodsThis was an explorative study involving 15 in-depth interviews among health professionals and private dispensers and eight focus group discussions among 55 community members. Qualitative data were coded using Nvivo 12, thematically analysed and presented as narratives with quotes to support the findings.ResultsSelf-medication was common and antibiotics were used to treat specific diseases but respondents were not aware these were ‘antibiotics’. Various antibiotics were used for indications that in principle do not require systemic antibiotics, like stomach ache and sores on the body. Antibiotics, in particular tetracycline and metronidazole, were poured into “akpeteshie” (local gin) to treat hernia and perceived stomach sores (stomach ulcer). These practices were copied/learnt from various sources like over-the-counter medicine sellers, family, friends, radio/television, drug peddlers, pharmacies and doctors. Medicines in capsules were referred to as ‘topaye’ or ‘abombelt’ in Twi (local dialect) and perceived to treat pain associated with diseases. Antibiotics in capsules were described with colours which appeared confusing as some capsules with different drugs in them have similar colours.ConclusionInappropriate antibiotic use were influenced by general lack of knowledge on antibiotics and identification of antibiotics by colours of capsules which leads to confusion and could lead to inappropriate antibiotic use. There is the need for public health education on appropriate antibiotic use and standardization of appearance of antibiotics and other drugs to optimize use.
Highlights
Inappropriate antibiotic use is an important driver of antibiotic resistance
This section is categorized into four sections: (i) demographic characteristics of the respondents (ii) antibiotic use for specific diseases (iii) how people learn about antibiotics and indications for use and (iv) confusion of antibiotics with other drugs
Findings from this study are in line with the principles of ethnomethodology research approach considering that this study focused on ordinary and routine forms of behaviour with regards to the meaning which underlies inappropriate antibiotic use
Summary
Inappropriate antibiotic use is an important driver of antibiotic resistance. This study sought to explore inappropriate antibiotic use and confusing antibiotics with other medicines in Ghana using ethnomethodology research approach. The upsurge in antibiotic resistance is largely attributed to inappropriate antibiotic use and poor infection control [1–3]. Though inappropriate antibiotic use is a global phenomenon [3], it is more prevalent in low and middle income countries (LMIC) especially in rural communities with poor access to approved healthcare providers [3, 4]. In LMIC, antibiotics are accessible and can be obtained without prescription from over-thecounter medicine sellers and official pharmacies [5, 6]. Inappropriate antibiotic use is associated with culture and community contextual factors such as selling or buying antibiotics without prescription and long distances to appropriate health care provider respectively [5, 7, 8]. Antibiotics are medicines that should only be used to treat bacterial infections and not diseases caused by viruses such as influenza or common cold, but this is not adhered to [9]
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