Abstract
BackgroundAntimicrobial resistance is a major consequence of irrational antimicrobial prescriptions and consumptions, but this can be prevented by antimicrobial stewardship. The study systematically reviewed available evidence on antimicrobial prescriptions and antimicrobial stewardship (AMS) programmes in Nigerian hospitals. This will provide insight to the extent of required interventions, for improved healthcare.Main bodyPublished research from January 1 2010 to March 31 2021 from PubMed, Scopus, Web of Science, African Journals Online and Google scholar databases was reviewed using Preferred Regulatory Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines 2009. Studies that reported antimicrobial use and antimicrobial stewardship programmes in Nigerian hospitals within the period in focus were assessed for eligibility. The National Heart, Lung and Blood Institute (NHLBI) quality assessment tool was used to assess quality of included studies. Among 15 studies included based on inclusion criteria, 12 reported on antimicrobial prescriptions and 3 reported on status of antimicrobial stewardship programmes in Nigerian hospitals. Most studies reported high prevalence of antimicrobials prescriptions with broad spectrum antimicrobials, majority of which were inappropriate. Empirical antimicrobial prescribing was common, and this was mostly done with less cognisance to existing guidelines. Only few hospitals were observed to have formal AMS teams in Nigeria.ConclusionInappropriate prescribing of antimicrobials was common among prescribers in Nigeria. Although there was paucity of studies on status of AMS, the available few showed very low prevalence of AMS teams in hospitals. There is urgent need for implementation of AMS in Nigerian hospitals, to enhance rational antimicrobial use. Meanwhile more research on AMS in Nigerian hospitals is needed.
Highlights
Antimicrobial resistance is a major consequence of irrational antimicrobial prescriptions and consumptions, but this can be prevented by antimicrobial stewardship
This study systematically reviewed available evidence on antimicrobial prescriptions for hospitalised patients, and status of antimicrobial stewardship programmes in Nigerian hospitals
Study eligibility After a careful assessment of titles and screening of abstracts of potential studies, only articles that reported studies on antimicrobial prescribing in Nigerian hospitals and the state of antimicrobial stewardship programmes in Nigerian hospital were assessed for eligibility
Summary
Antimicrobial resistance is a major consequence of irrational antimicrobial prescriptions and consumptions, but this can be prevented by antimicrobial stewardship. The study systematically reviewed available evidence on antimicrobial prescriptions and antimicrobial stewardship (AMS) programmes in Nigerian hospitals. This will provide insight to the extent of required interventions, for improved healthcare. Antimicrobial prescription is an important process of selecting and ordering for antimicrobials to proffer therapy or Iheanacho and Eze Futur J Pharm Sci (2021) 7:216 prevent microbial infections. It involves formulation of appropriate antimicrobial regimen from several options and requires rational prescription skills. Antimicrobial stewardship (AMS) teams and programmes are instituted to provide checks, and limit the occurrence of irrational antimicrobial prescriptions
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