Profile of Antimicrobial Drug Use Patterns in a Nigerian Metropolitan City

Purpose: To evaluate self-medication practices and prescribing patterns of antimicrobial agents. Methods: The study was carried out in Port Harcourt, Nigeria in 6 hospitals/clinics, 4 community pharmacies and the campus of University of Port Harcourt. 1,200 case files or charts of outpatients treated at the selected hospitals/clinics were reviewed for relevant information. Thereafter, independent physician assessors evaluated the “appropriateness” of antimicrobial prescribing. The antibiotic self-medication practices were assessed at the university campus and selected community pharmacies. Results: Metronidazole, ampicillin/cloxacillin (19%), amoxicillin (16%) and co-trimoxazole (12%) were the most frequently prescribed antimicrobials. Malaria (21%), followed by upper respiratory tract infection (19%), were the most frequent medical conditions in which antimicrobials were used. Over onehalf (56%) of the antimicrobial prescriptions were considered “appropriate” by the physician assesors; 23% of the cases “inappropriate”, while in 17% and 4% of cases, there were disagreement and query, respectively. There was a significant difference in the patterns of antimicrobial prescribing by physicians at both public and private hospitals, (χ 2 = 16.808, df = 3, P< 0.01). Cough (20%), stomach upset (20%) and boils (20%) were the most frequent conditions in which the respondents self-medicated with antimicrobials. Ampicillin (23%), co-trimoxazole (17%) and tetracycline (16%) were the frequently used antimicrobial agents. Conclusion: Antimicrobial drug use was common. Sometimes, the agents were inappropriately used by the public and private health facilities as well as members of the public through self-medication. Keywords: Antimicrobial drug, Prescribing patterns, Self-medication, Survey