Conference abstract

A systematic review on antibiotic use in humans in Nigeria

Pan African Medical Journal - Conference Proceedings. 2018:8(38).28 Dec 2018.
doi: 10.11604/pamj-cp.2018.8.38.620

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Keywords: Antibiotics, Nigeria, inappropriate prescribing, consumption, OTC drugs
Opening ceremony

A systematic review on antibiotic use in humans in Nigeria

Abiodun Egwuenu1,&, Busola Olayinka2, Yinka Apeji2, Olufemi Abayomi3, Adebola Olayinka3,4, Joshua Obasanya1, Chikwe Ihekweazu1

1Nigeria Center for Disease Control, Abuja, Nigeria, 2Department of Pharmaceutical Services, Ahmadu Bello University, Kaduna, Kaduna, 3Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria, 4Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria

&Corresponding author
Abiodun Egwuenu, Nigeria Center for Disease Control, Jabi, Abuja, Nigeria

Abstract

Introduction: Nigeria has the third highest percentage of antibiotic prescriptions at 48%, out of 12 African countries. However, this increasing trend in antibiotic consumption is contributory to antibiotic misuse, which is a key driver of the rising antimicrobial resistance (AMR) rates. The objectives of this systematic review are to describe the quantitative indicators of irrational antibiotic use and identify factors influencing use of antibiotics.

Methods: we searched for articles published in English between January 2000 till January 2017 from Medline via Pubmed and African Journals Online (AJOL) databases, using the following search terms: “rational use”, “antibiotic consumption”, “antimicrobials”, “Nigeria”, “purchase of antibiotics” and “over the counter”. This review was done using the preferred reporting system for systematic review and meta-analysis (PRISMA) statement. The two dimensions of irrational antibiotic use was searched for: prescription behavior by health workers and medicine use behavior by patients. Key indicators were extracted and summarized.

Results: a total of 11 articles were included in the final data synthesis of which all were cross-sectional design and for 2 (18%) articles, the study population were medical doctors. The proportion of irrational antibiotic use ranged from 31.7% to 71.1% while the percentage of antibiotics prescribed per patient encounters which ranged from 26.8% among persons =15 years to 71.1% in children <5 years with a median of 44.7%. The commonest antibiotic used or prescribed were the penicillin group of antibiotics ranging from 25% to 71.2%, with a median of 29.9%. Factors influencing irrational antibiotic use include over the counter (OTC) supply of antibiotics, patients’ demand for antibiotics, access to National Health Insurance. Prescribers’ characteristics included longer years of practice, lack of specialization and age.

Conclusion: our findings highlight the need for physician re-training and patient education on rational antibiotic us. National legislation on antibiotic sales based on prescription should be enforced and surveillance of antibiotic prescription per patient encounter at health facilities should also be prioritized. This information was used in the development of the National Action Plan on AMR in the country.