ABUTH Pharma Journal (2023) · 2023
Popoola et al.
Background: Antimicrobial resistance is one of the top 10 global health threats facing humanity. It causes an estimated annual death rate of 10 million, more than what is caused by cancer. Ascertaining the quality of drugs and ensuring rational prescribing can mitigate antimicrobial resistance and improve treatment outcomes in patients. Objective: To establish the antimicrobial resistance pattern among in-patient at a tertiary health care institution in northern Nigeria and to determine the role of drug quality in combating antimicrobial resistance. Method: Microbial culture sensitivity (MCS) results, drug quality control test results and drug stock availability data were collected using structured proforma from the department of microbiology, and pharmaceutical services (pharmacy bulk stores/chemistry and microbiology laboratories) respectively. The designed questionnaire was used to collect data on the antimicrobial prescribing habits of physicians. Result: An analysis of the antimicrobial resistance pattern of 496 isolates showed the most resistance to ceftazidime, amoxicillin, ciprofloxacin and ceftriazone, with the least resistance to imipenem, amikacin, chloramphenicol and cefotaxime. The trend of resistance was organism dependent with the most resistant organisms being Staphylococcus spp, Klebsiella spp, and Escherichia coli. A total of 92.86% of antimicrobials passed the quality control tests. We observed a possible association between antimicrobial availability and development of resistance. There is no statistically significant association (P>0.05) between rank of physicians and their compliance with rational antimicrobial selection. A total of 74.5% of the physicians cited availability of antibiotics as a limiting factor for prescribing and 97.1% expressed willingness to prescribe antibiotics in line with MCS results if available. Most expressed quality and cost as factors considered in making a decision. Conclusion: The quality and availability of antimicrobials may be predictive of the antimicrobial resistance pattern observed. Rational prescribing was largely influenced by the affordability and perceived quality of some brands of antimicrobials.
Volume: Vol. 1
Issue: No. 1
Pages: pp. 27–36
Year: 2023
Antimicrobial resistance (AMR) is one of the WHO's top 10 global health threats, projected to cause 10 million deaths annually by 2050. Drug quality and availability are believed to influence how resistance develops, particularly in settings with counterfeit or substandard antimicrobials.
A retrospective study at a tertiary hospital in northern Nigeria analyzed 496 microbial culture and sensitivity results alongside quality-control tests on antimicrobial stock and a physician questionnaire on prescribing habits, over six months.
Isolates showed the highest resistance to ceftazidime, amoxicillin, ciprofloxacin, and ceftriaxone, and the least to imipenem, amikacin, chloramphenicol, and cefotaxime; Staphylococcus spp., Klebsiella spp., and E. coli were the most resistant organisms. Of the antimicrobials tested, 92.86% passed quality-control checks. Most physicians (74.5%) cited drug availability as a limiting factor in rational prescribing, and 97.1% said they would prescribe in line with culture results if supply allowed.
Antimicrobial quality and availability appear predictive of the resistance pattern observed, and rational prescribing was strongly shaped by drug affordability and perceived quality.