Nigerian health workers overprescription of antibiotics by experts

Experts spoke during a virtual media dialogue hosted by St. Racheal’s Pharma to mark World Antimicrobial Awareness Week (WAAW) 2021.

Dr Esohe Ogboghodo, a public health doctor, said: “Antibiotics are over-prescribed by health workers.

“Sometimes due to patient demand when they are also overused by the public.

“Poor adherence to the prescription of antibiotics by individuals has also been blamed.

“Factors contributing to poor adherence to antimicrobial treatment include the financial inability to purchase the full dose, the long duration of treatment and the side effects experienced.

“In addition, unfinished doses of antimicrobials are usually kept for future use or given to others with similar problems. “

She also traced the causes of antibiotic resistance to factors such as unrestricted public access to antibiotics, which often leads to abuse.

Ogboghodo is also the Head of the Department of Public Health and Community Medicine at the University Hospital of Benin (UBTH) and the Chairman of the Department of Infection Prevention and Control at UBTH.

“Unrestricted access to over-the-counter antimicrobials at pharmacies, under-regulated patent drug vendors and hawkers may be the main driver of resistance in Nigeria.

“These stores often sell drugs that are not on the list of drugs approved for them.

In addition, there are also several street drug vendors who sell unapproved and often poor quality drugs to the public, including antimicrobial agents.

“The ease of access and overuse of antimicrobials has resulted in increasing bacterial resistance to antibiotics, which paradoxically leads to a loss of efficacy. “

On the consequences of antibiotic resistance, she said: “Antibiotics reduce a doctor’s treatment options, limiting the specific antibiotics suitable for this infection.

“Thus, the doctor is forced to choose an antibiotic which may be expensive or perhaps more toxic and whose pharmacokinetics are potentially moderate for a particular infection.

“It increases mortality. Many nosocomial infections are already caused by bacteria resistance to all known antibiotics, and many researchers believe we will return to the pre-antibiotic period.

“It increases human pain, infections become refractory, and the patient stays in the hospital longer than he would or is forced into the hospital because there is a need to use intravenous therapy.

“The appearance of resistance in hospitals is considered an indicator of poor quality care services” she said.

Another panelist, Dr Bamidele Mutiu, a clinical microbiologist consultant at Lagos State College of Medicine and Lagos State University Hospital, also blamed medical professionals for contributing to the antibiotic resistance situation in Nigeria .

According to him, some doctors are prescribing the drugs without proper investigation to ensure that antibiotics are needed or not.

“This year’s WAAW theme – ‘Spreading awareness, stopping the resistance’ should start with health practitioners.

“Whenever we come into contact with patients, inside and outside the hospital, we have to tell them ‘you don’t need antibiotics unless indicated, supported by laboratory diagnosis, microbiological evidence and susceptibility testing.

“I can tell you that we health workers are also to blame.

“For some of us, every patient they see, they add antibiotics to their prescriptions to increase the amount patients will pay and increase profits.

“We should look inside because we health workers have a role to play” he said.

The Managing Director of St. Racheal’s Pharma, Mr. Akinjide Adeosun, attributed the problem of antibiotic resistance in Nigeria to the country’s high direct health costs.

The pressure on patients to pay, he said, often leads to a sub-optimal purchase of antimicrobial doses, thereby encouraging microbials to be resistant to available drugs.

“I hereby declare my unequivocal support for the House of Representatives bill championed by the Hon. Bello Kaoje to make children’s health services free.

“This will revolutionize the care of children in Nigeria.

“This bill has passed second reading and must be supported by everyone.

“If parents don’t have to worry about out-of-pocket expenses, this will directly translate into the full distribution of antimicrobials, thus improving germ eradication and leading to a reduction in antimicrobial resistance.” he stressed.

The meeting advised against prescribing antibiotics based on unsubstantiated historical practice, patient demand, convenience or pressure from colleagues, delaying the appointment, or withholding the patient.

He also urged governments, doctors and stakeholders to make concerted efforts to preserve the few antibiotics currently on the market to ensure their continued effectiveness, as no new ones are currently being introduced.