Audit of Antibiotic Prescribing Patterns in a General Hospital in Lokoja, Kogi State

Irrational antibiotic prescribing is a primary driver of antimicrobial resistance in Nigeria and undermines the effectiveness of available therapeutic options. This retrospective cross-sectional audit examined antibiotic prescribing patterns at General Hospital Lokoja, Kogi State, in the North Central geopolitical zone of Nigeria. Prescription records for 500 outpatient and 300 inpatient cases from January to June 2024 were reviewed and analyzed against Nigeria's Standard Treatment Guidelines (STG) 2022. WHO prescribing indicators and the AWaRe classification were applied. Antibiotics were prescribed in 78.4 percent of all outpatient consultations, far exceeding the WHO recommended threshold of 20 to 26.8 percent for similar settings. Amoxicillin-clavulanate and metronidazole were the most frequently prescribed antibiotics. Culture-guided therapy was documented in only 8.2 percent of inpatient antibiotic prescriptions. Access group antibiotics (WHO AWaRe) accounted for 52 percent of prescriptions, while Watch group antibiotics constituted 44 percent, and Reserve group antibiotics 4 percent. Antibiotic prescription without established clinical indication was documented in 31 percent of outpatient cases. These results reflect significant antibiotic over-prescribing and poor rational medicine use practices at General Hospital Lokoja. The study recommends prescribing audits at six-monthly intervals, distribution of updated STGs, pharmacist-led prescribing reviews, and implementation of diagnostic-linked prescribing policies. Keywords: antibiotic prescribing, audit, Lokoja, rational medicine use, antimicrobial stewardship.