Antimicrobial utilization in University of Benin Health Care Centre, Benin City, Edo State, Nigeria

Abstract

Purpose: The study evaluated the antimicrobial utilizations pattern in the University of Benin Health Centre, with a view to appraising the level of compliance of the Centre to WHO guidelines for rational use of antimicrobial agents. Methods: This was a descriptive cross-sectional prospective study of case files of 200 patients who attended the health centre from 30th May to June 29th 2017. A data collection form was used to collect the following information; name of antibiotics prescribed, indication for use, pattern of combination therapy, justification for antibiotic prescription (laboratory investigation), cost of antibiotic utilization as well as the age and gender of patients. All the case files of patients who were prescribed antibiotics during the study period were screened. Results: A total of 200 prescription encounters were evaluated. Children aged 0-9 years and young adults (20-39 years) were the highest recipients of antibiotics while patients aged 60 years and above received the least number of antibiotics. Malaria fever (31.8%) and respiratory tract infections (28.0%) accounted for the indications that received the highest number of antibiotic prescriptions among the 10 indications for antibiotic utilization. Beta-lactam antibiotics were the most prescribed class of antibiotics both in combination and as a single therapy. The average number of medicines per prescription was 3.71 and percentage of antibiotic prescriptions was 34.2%. Generic prescribing was at 38.0%, while laboratory investigations was 8.5%. However, the percentage cost of encounter was 30.6%. Conclusions: The low rate of percentage cost of antibiotics was rational in comparison with WHO standard range. But the higher than recommended standard for indicators such as average number of medicines per encounter, percentage of antibiotics prescribed and low rate of laboratory investigations implies irrational prescribing. Brand name prescribing was also common and irrational. Thus, there is high rate of irrational prescribing of antibiotics in the study centre and this could further worsen the burden of microbial resistances to these antibiotics. Keywords: Antimicrobials, compliance, guidelines, utilization