Antibiotic prescribing patterns was studied from 700 retrospective outpatient clinical records from seven government health facilities in the Wassa West district of Ghana. Prescribing patterns were compared between the district hospital and six health centres. The percentage of patients receiving one or more antibiotics was significantly more at the health centres(60.7%) than at the hospital(41.0%) (chi 2 = 13.6; p < 0.001). The average number of antibiotics prescribed per patient was 1.4 and 1.1 respectively. The commonest antibiotics prescribed were procaine penicillin, cotrimoxazole, benzylpenicillin, metronidazole and amoxycillin. Malaria, upper respiratory infections, soft tissue infections and diarrhoeal diseases were the commonest indications for antibiotic use. Factors such as the availability of diagnostic facilities, type of prescriber, lack of refresher training and patient demand were considered to significantly influence antibiotic prescribing.