Exposure of consumers to substandard antibiotics from selected authorised and unauthorised medicine sales outlets in Ghana

Objective To assess the quality of antibiotics sampled from authorised sales outlets (ATs) (i.e. hospitals/health centres, pharmacies and licensed chemical shops) and unauthorised sales outlets (UATs) (mainly street vendors) in Ghana and to explore the health‐seeking behaviour of medicine consumers. Methods The contents of 14 active pharmaceutical ingredients (APIs) in 348 sampled products were determined using a validated liquid chromatography–tandem mass spectrometry (LC‐MS/MS) method. Data on health‐seeking practices were collected through entry and exit interviews and field observations from ATs and UATs. Results It was observed that 66.38% of all sampled antibiotic products were substandard; they either contained less (110%) than the label claim. Medicines from UATs recorded substantially less API contents than those from ATs (F(2,419) = 43.01, P