Evaluation of One-Year Antibiotics Utilization in the Adult Outpatient Pharmacy of a Nigerian Tertiary Health Institution

Abstract Background: Antibiotics are among the most common drugs used worldwide.They kill or prevent the growth of bacterial microorganisms in the body, hence, they are the major agents used in treating bacterial infections. Because they are prone to abuse and misuse, regular evaluation of their utilization is important for optimal healthcare delivery.Objective: This study determined the antibiotics type, utilization, prescriptions and cost patterns in the adult out-patient pharmacy of a public tertiary health facility in Nigeria.Methods: This is a retrospective observational study using medication utilization records (prescriptions) to investigate the study objectives. Prescriptions dispensed in 2018 in adult out-patient pharmacy of Nnamdi Azikiwe University Teaching Hospital, Nnewi were reviewed. Data were evaluated using the World Health Organization-developed prescribing indicators. Descriptive and inferential statistics were used to analyze the results. The percentage and averages of the variable were calculated.Results: The medication utilization records showed that there was a significantly higher proportion (P-value = 0.0038) of females (70%) compared to males (the ratio being 2.44:1.00) that were prescribed antibiotics. The antibiotic utilization profile showed that antibiotic selection by class was significantly different and accounted for 44.02% of the total variance seen in the prescription pattern (P-value is < 0.0001). Also, the age of participants accounted for 19.48% of the total variance seen in the selection practice and so, age significantly affected the selection practice/prescription pattern with P-value < 0.0001. Dosage forms profile showed that the oral dosage forms were significantly more prescribed (P-value < 0.0001) compared with any other dosage form encountered in the study. There was no significant difference in the prescription patterns of parenteral and other dosage forms (P-value > 0.05). A greater percentage (84.22 %) of the prescriptions was from the Essential Drug list of Nigeria. Conclusion: Though the percentage of antibiotics prescribed from essential medicines list was found to be satisfactory, a strict protocol for prescribers is required to promote rational antibiotics use. This would not only prevent antibiotic resistance but also reduce the treatment expenditure and encourage antibiotic stewardship.