Empirical Antibiotic Prescription Pattern among Patients in a Nigerian Tertiary Hospital, is There Evidence of Irrationality?

Background: Resistance to antibiotics is spreading rapidly around the world with its associated morbidity and mortality. Infections are becoming increasingly difficult to treat resulting in increased cost of medical care. In low income countries with high infectious disease burden, antibiotic resistance is reported to be accelerated by irrational prescriptions in health facilities. In the absence of adequate resources, many clinicians engage in empirical antibiotic prescriptions some of which their appropriateness is questionable. There is need for laboratory evidence to justify empirical antibiotic use in the light of increasing resistance to commonly prescribed antibiotics.

Aims: This study aims to determine empirical antibiotic prescription pattern and to determine rationality using resistance profile of common bacterial isolates in hospitals.

Methods: Antibiotic prescriptions in the NHIS department and antibiogram records were obtained from pharmacy and laboratory records respectively. Analysis was carried out using descriptive statistics and comparison between antibiotics prescribed and their respective resistance pattern were compared to determine rationality.

Results and Discussion: The Penicillins and Quinolones were the most prescribed class of antibiotics and resistance range between 30 – 90% and 3 – 23% respectively. Resistance to other antibiotics was high thus making empirical prescriptions irrational in most of the cases. These findings have been consistently reported in several studies so widespread empirical antibiotic prescriptions are not in tandem with principles of rational drug use.

Conclusion: Antibiotic resistance is common among hospital isolates, so there is need to emphasize that prescriptions be based on laboratory evidence of microbial sensitivity.