OBJECTIVES

Antibiotics are one of the most commonly prescribed drugs among hospitalized patients. Their inappropriate use leads to antibiotic resistance and increased medical cost. The study seeks to assess antibiotic use pattern among hospitalized patients in University of Port Harcourt Teaching Hospital (UPTH), using seventeen (17) core antimicrobial drug use indicators developed under the Rational Pharmaceutical Management Plus (RPM-Plus) Program of Management Sciences for Health and revised under the Strengthening Pharmaceutical Systems (SPS) Program.

METHODS

A cross-sectional survey was conducted in medical, surgical, paediatrics, and obstetrics and gynaecology wards from October 2015 to March 2016. A total of 2356 patients’ folders were reviewed retrospectively. Additionally, 16 inpatient physicians were interviewed to understand the reason behind the antibiotic prescribing practice observed.

RESULTS

Antibiotics were prescribed in 68.8% of hospitalizations. Of 4669 antibiotics prescribed, 84.2 % appeared on the essential medicine list, 60.4% were injections, but only 1861 (39.9%) were prescribed in generic form. Each patient, on an average, was prescribed 2.74 antibiotics per hospitalization. Cephalosporins (33.6%) were the most commonly prescribed antibiotics. The average cost of antibiotics prescribed per hospitalization was ₦13,632.00 (USD 37.9) and percentage of prescribed antibiotics actually administered was 87.4%. Only 11.5% of antibiotic prescribed was based on microbial sensitivity test (MCST) result. Physicians reported certain factors that influenced the pattern of antibiotic utilization observed such as poor laboratory services, drug cost etc. Key antibiotics available at the time of the study were only 62.2% and there was no Drug and Therapeutics Committee (DTC) or other systems regulating antibiotics use at UPTH.

CONCLUSIONS

The use of antibiotics use in UPTH did not conform to acceptable standards. The establishment of local protocols and other systems regulating antibiotics use including an antibiotic stewardship program could improve rational antibiotic use, curtail health care costs and result in substantial savings.