OBJECTIVES : There is paucity of data describing the quantity of antibiotics used among hospitalized patients in Nigeria. This study describes the quantity of antibiotics (in defined daily dose [DDD]) used among hospitalized patients using the World Health Organization access, watch and reserve (AWaRe) criteria.

METHODS : A point-prevalence survey was conducted in three acute care hospitals among patients who were admitted before or at 8:00 a.m. on the day of the survey. The data was collected through the review of patient’s medical record in April and May 2019. Antibiotics prescribed, used or scheduled to be used on the day of the survey were recorded including the route of administration, dose, and frequency.

RESULTS : A total of 321 hospitalized patients were surveyed and 215 adult patients were included in this analysis. The total quantity of antibiotics prescribed was 116.6 DDD/100 patients with cephalosporins (36 DDD/100 patients), imidazoles (31.6 DDD/100 patients), penicillins (18.6 DDD/100 patients) and fluoroquinolones (16.5 DDD/100 patients) accounting for 30.9%, 27.1%, 16.0% and 14.2% of the total quantity, respectively. Oral antibiotics accounted for 44.3% of the prescriptions and 57.3% of the total quantity of antibiotics used. The access group of antibiotics represented < 50% of the total quantity of antibiotics used while watch group of antibiotics constituted approximately 50%. Reserve group antibiotics were not prescribed on the day of the survey.

CONCLUSIONS : Antibiotics are overused among hospitalized patients. There was excessive use of antibiotics in the watch group which are associated with a high risk of antibiotic resistance, and lesser use of the access group antibiotics that have lower risk of resistance in comparison to other countries. Antimicrobial stewardship program that prioritizes reducing antibiotic overuse, reduce the excessive use of watch group antibiotics and promotes assess to reserve group antibiotics when they are needed is recommended.