Antimicrobial stewardship practice in Tertiary Hospitals of North Central Region of Nigeria

Abstract

Introduction: Antimicrobials are currently the most customarily prescribed drugs in the community as well as in healthcare settings. Since their introduction into clinical practice, inappropriate use of antimicrobials and associated AMR have become challenges faced by humans. Concern has been raised about low-quality practices; profit aspirations, non-enforcement of legislation and improper knowledge of the general population about this problem. In the past two decades, this issue has become increasingly urgent and constitutes a major threat to public health. Methods: This study was conducted to identify current aspects and patterns to antimicrobial prescribing among Medical Doctors in the Federal Medical Centre (FMC), Keffi and the University of Abuja Teaching Hospital (UATH), Gwagwalada in Nigeria. The objective for the study was to provide baseline data in the two hospitals and identify priorities for improvement. The questionnaire was targeted at 355 Medical doctors spread out as Consultants, 75; Resident doctors, 180 and House officer doctors, 100 from the two sites. Institutional Ethics Committee permission from each tertiary institution was obtained prior to the initiation of the study at site. The questionnaire interrogated several aspects of interest, demographic status, knowledge of antimicrobial classification, practical use of antimicrobials and knowledge of antimicrobial resistance. Results: Of the one hundred and eighty questionnaires that were returned to us, one hundred and forty-two (78.88%) were returned with a signed consent page attached. Among these doctors, ninety-five were male (66.90%). As to workplace experience, 10 (7.0%) had up to 30 years of medical practice experience, Among these doctors, 40 (28.2%) are Consultants and 47 (33.1%) are House Officers, Of all the respondents, 130 (91.5%) are not aware of this NICE document, 10 (7.0%) individuals have discussed it within their units, but 4 (2.8%) individuals did not respond to the question. About 141 (99.29%) respondents accepted that antimicrobial resistance is a real threat to patient care except one (0.70%). Are you willing to participate in any clinical interventions involving antimicrobial use?’ One hundred and twenty-four (87.3%) doctors answered yes, 11 (7.7%) answered no, 3 (2.1%) were uncertain, while 4 (2.8%) did not respond to the question. Conclusion: We concluded that antimicrobial stewardship is a dynamic programme, and that the tools for ASP if implemented diligently are the most effective means by which we may save ourselves from the looming disaster that AMR will cause.