A Review of the use of Rational and Quality Antibiotics in a Nigerian Tertiary Institution

Authors

  • Asogwa I. C
  • Chiojioke-Nwauche I
  • Otuku E. I
  • Ekwunife O. I

DOI:

https://doi.org/10.47672/ajhmn.1282

Keywords:

Antibiotics, generic names, essential medicine list, prescription, rational drug use.

Abstract

Purpose: The study reviewed the use of rational and quality antibiotics at the Federal Medical Centre, Yenagoa, Bayelsa State. Three objectives and three research questions were drafted for the study, respectively.

Methodology: The study used a retrospective descriptive survey that lasted four months. The study relied on secondary data, which was gathered from the folders of 583 patients. From January 1, 2019 to April 30, 2019, all patients with complete information admitted to medical, surgical, and paediatric wards, as well as obstetrics and gynaecology wards, had their folders reviewed. A self-developed checklist was used to assess critical aspects of antibiotic utilisation and the use of generic names in antibiotic prescribing, a self-developed checklist was used. The data collected were collated, coded and analysed using descriptive statistics of frequency, percentage, charts, and tables.

Findings: The findings showed that out of the total folders (n=583) reviewed, the socio-demographic information showed that majority of the patients (42.2%) who received prescribed antibiotics were adult female. On the age category, out of the total folders (n=583) reviewed, majority of the folders (114) showed that those within the ages of 21-30 years represents over 19.0%. The antibiotics prescribed from the four (4) different departments showed that 26.7% of antibiotics were prescribed and utilized in medical wards. The level of compliance with some standard practices, shows that pneumonia test conducted, was highest in surgery ward, this represents 82.8%, the sensitivity test conducted, was highest in paediatric ward (46.4%). Out of the total antibiotics prescribed (n=1164), generic names were used for 59.6% cases, while 73.2% of the antibiotic prescribed were in the EDL authorised list. The results revealed that cephalosporins were the most commonly prescribed class of antibiotics, 384 (34%) followed by the nitroimidazoles 346 (29.7%) and penicillin's 138 (11.9%). Inappropriate antibiotic prescription was found to be 58.7% among the total prescribed antibiotics (n=1164).  Based on the results and findings in the study, it is safe to conclude that the majority of antibiotics utilised were over prescribed, with high inappropriate use. The lack of generic use in antibiotic prescriptions and the overuse of antibiotics remain a problem in tertiary hospitals across Nigeria.

Recommendation: This study recommend that prescriptions should be prescribed with slips duly signed by a doctor and approved by a pharmacist before the administration of such drugs. Also, all public hospitals in Nigeria should develop local treatment guidelines using national and international policy guidelines for local infectious disease.

Downloads

Download data is not yet available.

Author Biographies

Asogwa I. C

Nnamdi Azikiwe University, Faculty of Pharmaceutical Sciences, Department of Clinical Pharmacy and Pharmacy Management.

Chiojioke-Nwauche I

University of Port Harcourt, Faculty of Pharmaceutical Sciences, Department of Clinical Pharmacy and Pharmacy Management.

Otuku E. I

SeatsGroup Research Centre, Port Harcourt

Ekwunife O. I

Nnamdi Azikiwe University, Faculty of Pharmaceutical Sciences, Department of Clinical Pharmacy and Pharmacy Management.

 

References

Abdu-Aguye, S. N., Haruna, A., Shehu, A., and Labaran, K. S. (2016). An assessment of antimicrobial prescribing at a tertiary hospital in north-western Nigeria. African Journal of Pharmacology and Therapeutics, 5(4).

Abubakar, U. (2020). Antibiotic use among hospitalized patients in northern Nigeria: a multicenter point-prevalence survey. BMC infectious diseases, 20(1), 1-9.

Abula, T., and Kedir, M. (2004). The pattern of antibiotic usage in surgical in-patients of a teaching hospital, northwest Ethiopia. The Ethiopian Journal of Health Development, 18(1)

Adisa, R., Orherhe, O. M., and Fakeye, T. O. (2018). Evaluation of antibiotic prescriptions and use in under-five children in Ibadan, SouthWestern Nigeria. African health sciences, 18(4), 1189-1201

Alfa, J., and Adigwe, O. P. (2014). Rational use of medicines in Nigeria: A critical review. J Biol Agric Healthc, 4, 89-99.

Apisarnthanarak, A., Danchaivijitr, S., Khawcharoenporn, T., Limsrivilai, J., Warachan, B., Bailey, T. C., and Thammasart university Antibiotic Management Team. (2006). Effectiveness of education and an antibiotic-control program in a tertiary care hospital in Thailand. Clinical infectious diseases, 42(6), 768-775.

Ashiru-Oredope, D., Sharland, M., Charani, E., McNulty, C. and Cooke, J. (2012). Improving the quality of antibiotic prescribing in the NHS by developing a new Antimicrobial Stewardship Programme: Start Smart"”Then Focus. Journal of antimicrobial chemotherapy, 67(suppl_1), i51-i63.

Atif, M., Azeem, M., Saqib, A., and Scahill, S. (2017). Investigation of antimicrobial use at a tertiary care hospital in Southern Punjab, Pakistan using WHO methodology. Antimicrobial Resistance & Infection Control, 6(1), 1-12.

Brink, A. J., Mendelson, M., Van den Bergh, D., and Richards, G. A. (2016). Passing the baton to pharmacists and nurses: new models of antibiotic stewardship for South Africa?: guest editorial. South African Medical Journal, 106(10), 947-948.

Buccellato, E., Melis, M., Biagi, C., Donati, M., Motola, D., and Vaccheri, A. (2015). Use of antibiotics in pediatrics: 8-years survey in Italian hospitals. PLoS One, 10(9), 1-10.

Chijoke-Nwauche, I. N., Chukwumezie, C. A., and Udezi, T. W. (2018). Prescribing indicators: a review in the general outpatient clinic of a Nigerian Tertiary Hospital. Journal of Health Science Research, 10-15.

Cantas, L., Shah, S. Q. A., Cavaco, L. M., Manaia, C., Walsh, F., Popowska, M., and Sørum, H. (2013). A brief multi-disciplinary review on antimicrobial resistance in medicine and its linkage to the global environmental microbiota. Frontiers in Microbiology, 4, 96..

Ceyhan, M. E. H. M. E. T., Yildirim, I., Ecevit, C., Aydogan, A., Ornek, A., Salman, N., and Coskun, Y. (2010). Inappropriate antimicrobial use in Turkish pediatric hospitals: a multicenter point prevalence survey. International Journal of Infectious

Charani, E., Cooke, J., and Holmes, A. (2010). Antibiotic stewardship programmes"”what's missing?. Journal of antimicrobial chemotherapy, 65(11), 2275-2277.

Chijoke-Nwauche, I. N., Chukwumezie, C. A., & Udezi, T. W. (2018). Prescribing indicators: a review in the general outpatient clinic of a Nigerian Tertiary Hospital. Journal of Health Science Research, 10-15.

Cooke, F. J., and Holmes, A. H. (2007). The missing care bundle: antibiotic prescribing in hospitals. International journal of antimicrobial agents, 30(1), 25-29.

Erah, P. O., and Ehiagwina, M. O. (2010). Assessment of rational prescribing and relative cost of antibiotics for in-patients treated in selected tertiary health care facilities in Southern Nigeria. International Journal of Pharma and Bio Sciences, 1(1), 1-15.

Goff, D. A., and Rybak, M. J. (2015). Global antimicrobial stewardship: challenges and successes from frontline stewards. Infectious Diseases and Therapy, 4(1), 1-3.

Israel, E. U., Sylvester, E. G., and Akwaowoh, A. E. (2015). The use of antibiotics in a Nigerian tertiary healthcare facility. Am J Biomed Sci Engineering, 1(3), 25-31.

Katzung, B. G. (2017). Basic and clinical pharmacology. McGraw-Hill Education.

Kebede, H. K., Gesesew, H. A., Woldehaimanot, T. E., and Goro, K. K. (2017). Antimicrobial use in paediatric patients in a teaching hospital in Ethiopia. PLoS One, 12(3), 1-8.

Llor, C., Bjerrum, L., Munck, A., Cots, J. M., Hernández, S., and Moragas, A. (2014). Access to point-of-care tests reduces the prescription of antibiotics among antibiotic-requesting subjects with respiratory tract infections. Respiratory Care, 59(12), 1918-1923.

Mugada, V., Paruchuri, A., and Munagala, M. (2016). Drug utilization evaluation of anticancer drugs in a tertiary care teaching hospital: A descriptive observational study. Journal of Applied Pharmaceutical Science, 6(10), 098-101.

Nwolisa, C. E., Erinaugha, E. U., and Ofoleta, S. I. (2006). Prescribing practices of doctors attending to under fives in a children's outpatient clinic in Owerri, Nigeria. Journal of tropical pediatrics, 52(3), 197-200.

Oduyebo, O. O., Olayinka, A. T., Iregbu, K. C., Versporten, A., Goossens, H., Nwajiobi-Princewill, P. I., ... and Ogunsola, F. T. (2017). A point prevalence survey of antimicrobial prescribing in four Nigerian tertiary hospitals. Annals of Tropical Pathology, 8(1), 42.

Ogunleye, O. O., Fadare, J. O., Yinka-Ogunleye, A. F., Anand Paramadhas, B. D., and Godman, B. (2019). Determinants of antibiotic prescribing among doctors in a Nigerian urban tertiary hospital. Hospital practice, 47(1), 53-58.

Onubogu, U. C., and Anochie, I. C. (2014). Empiric Antibiotic prescription among febrile under-five children in the University of Port Harcourt Teaching Hospital, Rivers state, Nigeria. Nigerian Journal of Paediatrics, 41(3), 234-238.

Pradeepkumar, B., Alameri, T., Narayana, G., Reddy, Y. P., and Ramaiah, J. D. (2017). Assessment of antibiotic prescribing pattern in pediatric patients: A cross-sectional hospital-based survey. CHRISMED Journal of Health and Research, 4(4), 235.

Raveh, D., Levy, Y., Schlesinger, Y., Greenberg, A., Rudensky, B., and Yinnon, A. M. (2001). Longitudinal surveillance of antibiotic use in the hospital. Qjm, 94(3), 141-152.

Schroder, W., Sommer, H., Gladstone, B. P., Foschi, F., Hellman, J., Evengard, B., and Tacconelli, E. (2016). Gender differences in antibiotic prescribing in the community: a systematic review and meta-analysis. Journal of Antimicrobial Chemotherapy, 71(7), 1800-1806.

Skender, K., Singh, V., Stalsby-Lundborg, C., and Sharma, M. (2021). Trends and patterns of antibiotic prescribing at orthopedic inpatient departments of two private-sector hospitals in Central India: A 10-year observational study. PloS one, 16(1), e0245902.

Tamuno, I., and Fadare, J. O. (2012). Drug prescription pattern in a Nigerian tertiary hospital. Tropical Journal of Pharmaceutical Research, 11(1), 146-152.

Umar, L. W., Isah, A., and Shuaibu Musa, B. U. (2018). Prescribing pattern and antibiotic use for hospitalized children in a Northern Nigerian Teaching Hospital. Annals of African medicine, 17(1), 26-32.

Umar, L. W., Isah, A., Musa, S., and Umar, B. (2020). Outpatient prescribing and antibiotic use for children in a tertiary hospital. Sahel Medical Journal, 23(2), 109.

Umeokonkwo, C. D., Madubueze, U. C., Onah, C. K., Okedo-Alex, I. N., Adeke, A. S., Versporten, A., and Onoh, R. (2019). Point prevalence survey of antimicrobial prescription in a tertiary hospital in South East Nigeria: a call for improved antibiotic stewardship. Journal of global antimicrobial resistance, 17, 291-295.

Woldu, M. A., Suleman, S., Workneh, N., and Berhane, H. (2013). Retrospective study of the pattern of antibiotic use in Hawassa University referral hospital pediatric ward, Southern Ethiopia. Journal of Applied Pharmaceutical Science, 3(2), 93-98.

Xiao, Y., Zhang, J., Zheng, B., Zhao, L., Li, S., and Li, L. (2013). Changes in Chinese policies to promote the rational use of antibiotics. PLoS medicine, 10(11), e1001556.

Downloads

Published

2022-11-18

How to Cite

Asogwa , I. C., Chiojioke-Nwauche, I., Otuku , E. I., & Ekwunife , O. I. (2022). A Review of the use of Rational and Quality Antibiotics in a Nigerian Tertiary Institution. American Journal of Health, Medicine and Nursing Practice, 7(12), 12–21. https://doi.org/10.47672/ajhmn.1282