Compliance with the primary health care treatment guidelines and the essential medicines list in the management of sexually transmitted infections in correctional centres in South Africa: findings and implications

Background: The emergence of antimicrobial resistance (AMR) is a global concern and a growing health crisis. Additionally, evidence has shown that non-compliance to treatment guidelines, especially in the management of communicable diseases such as sexually transmitted infections (STIs), has the potential of further enhancing AMR rates. Data on the extent of these challenges in Primary Health Care (PHC) facilities in correctional centres in South Africa (SA) is limited. Hence this study was conducted to determine the level of compliance with the 2008 PHC Standard Treatment Guidelines and Essential Medicines List (PHC STGs/EML) in the management of STIs in South Africa, and to identify potential factors contributing to the compliance and non-compliance to guide future strategies. Method: An investigational descriptive study, including retrospective and prospective data, was conducted over an eight month period. Results: Male urethritis syndrome, lower abdominal pain and genital ulcer syndrome were the three most common STIs. Doxycycline, ciprofloxacin and metronidazole were prescribed for most of the STIs. Overall compliance with the 2008 PHC STGs/EML was low for all STIs. Conclusion: The study highlights the need to implement antimicrobial stewardship programmes, including educational activities, to promote the rational use of antimicrobials and monitor their use in PHC facilities in SA.