Student , Nnamdi Azikiwe University, Awka, Nigeria
To assess antibiotic use and prescribing practice in an inpatient hospital setting
Temedie TC1 and Ekwunife OI2
Department of Pharmacy, University of Port Harcourt Teaching Hospital, Nigeria
Department of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Nigeria.
Background: Antibiotics are one of the most commonly prescribed drugs among hospitalised patients. Their inappropriate use has lead to antibiotic resistance and increased medical cost. Similar studies in Nigeria employed drug utilization tool unsuitable for in-patient surveys and only reported the antibiotics use patterns that were observed without probing further why. This study however seeks to fill this knowledge gap by employing seventeen core inpatient antimicrobial use indicators developed under the Rational Pharmaceutical Management Plus (RPM-Plus) Program of Management Sciences for Health and revised under the Strengthening Pharmaceutical Systems (SPS) Program. It is the first of its kind in the country. Purpose: To assess antibiotic use pattern among hospitalised patients in University of Port Harcourt Teaching Hospital (UPTH). Method: A cross-sectional survey was conducted in medical, surgical, paediatrics, and obstetrics and gynaecology wards from October 2015 to March 2016. A total of 2356 patients’ folders were reviewed retrospectively and data obtained statistically analysed. Additionally, sixteen inpatient physicians were interviewed to understand the reason behind the antibiotic prescribing practice observed. Results: Antibiotics were prescribed in 68.8percent of hospitalizations. Only 84.2 percent appeared on the essential drug list, 60.4 percent were injections and 39.9 percent were prescribed in generics. Each patient was prescribed 2.74 antibiotics at ₦13,632.00 cost averagely per hospitalization. Cephalosporin antibiotics were most commonly prescribed. The percentage of prescribed antibiotics actually administered was 87.4 percent, while 88.5% were empirically prescribed. Only 62.2 percent of key antibiotics were available and there was no systems regulating antibiotics use at UPTH. Physicians reported certain factors influenced the antibiotic use pattern observed. Conclusion: Antibiotics use in UPTH did not conform to acceptable standards. Establishment of local protocols and systems regulating antibiotics use including an antibiotic stewardship programme could improve rational antibiotic use; curtail cost and result in substanti
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