Antimicrobial stewardship practices and patterns of antibiotic dispensing among retail drug outlets in Ghana

Background Self-medication with antibiotics purchased from community retail drug outlets without valid prescriptions has emerged as a major contributor to antimicrobial resistance. This study evaluated antimicrobial stewardship practices related to antibiotic dispensing among community retail drug outlets in Ghana to identify current practices and inform targeted interventions to improve rational antibiotic use. Methods A cross-sectional study design was used. Data was collected from 158 dispensers, entered, and analyzed using STATA between April and July 2024. Descriptive statistics (mean, SD, median frequency, and percentages) were used to analyze antimicrobial stewardship practices, antibiotic types dispensed, associated diseases and conditions, and influencing factors of antibiotic dispensation without prescription. Chi-square (χ²), bivariate, and multivariate logistic regression analyses identified significant predictors of antibiotic dispensing without prescription and predictor variables. Results A total of 86 (54.4%) out of 158 respondents dispensed antibiotics without valid prescription, with 80.4% (127) dispensing without a prescription regularly. Ciprofloxacin and amoxicillin (65.8%) were most frequently dispensed, while genitourinary infections (74.7%) were the most common disease conditions for which treatment is given before medications used in treatment. Pharmacists (AOR = 4.63, 95% CI: 1.20-17.83; p = 0.026) were significantly more likely to engage in non-prescription dispensing than other dispensers. Dispensers who requested a history of the client’s history on antibiotic usage (AOR = 0.30, 95% CI: 0.10–0.89; p = 0.03) were less likely to dispense antibiotics without a prescription compared to those who did not request clients’ antibiotic use history. P-values less than 0.05 (p < 0.05) were considered statistically significant associations. Conclusion A high non-prescription sale of antibiotics in retail drug outlets was found in this study, underscoring the urgent need for improved antimicrobial stewardship measures through community-targeted evidence-based interventions.