Determination of Antibiotic Prescription Pattern in Private Healthcare Facilities in Port Harcourt Metropolis, Rivers State, Nigeria

Abstract

Background: The consequences of antimicrobial resistance are severe, as mortality and morbidity rates continue to increase. The extensive use of antibiotics contributes significantly to the development and spread of antimicrobial resistance. It is crucial to have knowledge supported by data to improve antimicrobial stewardship and address the growing problem of antimicrobial resistance globally and locally. Thus, an evaluation was conducted to assess the prescription practices of doctors working in private medical facilities in Port Harcourt, Rivers state, Nigeria. Methods: A cross-sectional survey was carried out using a structured questionnaire to collect information on medical training and antibiotic prescription practices among 102 medical doctors. Data was analyzed at a 95% confidence interval using the SPSS v25 software and a p-value less than 0.05 was considered significant. Results: The respondents' demographics indicated that 67.6% were male, while 32.4% were female practitioners. The majority, about 60.8%, had MBBS only, while 21.6% had a postgraduate medical fellowship and 17.6% had postgraduate degrees (PGD/MSc/PhD). The data revealed that 35.3% of the respondents had practiced for at least 15 years, while 33.3% had practiced for 1-5 years and 23.5% for 6-10 years. Cephalosporins were commonly prescribed by 43.1% of the respondents, with cefuroxime being the most frequently prescribed. Amoxicillin was prescribed by 20.6% of the respondents, while only 2.9% of them indicated prescribing Penicillins V or G. Laboratory investigations were the basis for prescribing antibiotics in 30.4%, while 69.6% prescribed on an empirical basis. The cross-tabulation of basis of prescriptions with qualifications showed that persons with postgraduate medical fellowship (86.4%) mostly prescribed based on clinical judgment, while individuals with MBBS only least commonly prescribed by clinical judgment. The prescription by empirical assessment was also mostly common among individuals with 6-10 years of practice experience (75%). However, no statistically significant association was found between the basis of prescriptions and academic qualifications or years of practice. Conclusion: The study's results revealed that doctors in private medical facilities in Port Harcourt have a strong inclination towards prescribing cephalosporins, particularly on empirical grounds rather than laboratory investigations. It is highly recommended to take immediate measures to promote the implementation of antimicrobial stewardship principles to address the local rise in antimicrobial resistance.