Improved Antibiotic Prescribing for Acute Conjunctivitis After Operational Research: A 2021–2024 Study in a Ghanaian Eye Hospital

Empirical antibiotic treatment is common in acute conjunctivitis despite most cases being non-infectious or viral infections. Operational research (OR) at an Eye Hospital in Ghana (Jan-Dec 2021) identified appropriate antibiotic prescription in 71% of cases. A campaign of research dissemination and sensitisation of key stakeholders followed, which included communicating the findings and implications to prescribing staff at the hospital. We conducted further OR covering the period Jan-Dec 2024 to test the hypothesis that appropriateness of antibiotic prescriptions will improve, to investigate the types of antibiotics prescribed and to evaluate the appropriateness of non-prescription of antibiotics. We found antibiotic prescription appropriate in 87% of cases, a 16% improvement on the 2021 findings. In 91% of all cases, the use or non-use of antibiotics was assessed as appropriate. All antibiotics used in 2021 were in ACCESS and WATCH categories. However, 15% of 2024 prescriptions were RESERVE antibiotics. This could have been driven by stock outs of ACCESS or WATCH alternatives. This research has demonstrated the power of regular operational research and interventions to improve antibiotic prescribing in eye health in Ghana. It is imperative that the recommendations of the initial researchers are fully implemented, to protect the future efficacy of available antibiotics.