Assessment of Antibiotic Prescribing Patterns in a Tertiary Hospital in Kano State

Irrational antibiotic prescribing is a major contributor to antimicrobial resistance, which poses a growing public health threat across Nigeria. This study assessed antibiotic prescribing patterns at Aminu Kano Teaching Hospital in Kano State, North West Nigeria, using a retrospective cross-sectional design. Prescription records from the outpatient pharmacy department for a twelve-month period (January to December 2023) were retrieved and analysed. A total of 1,200 prescriptions were systematically sampled. Data were extracted for antibiotic class, indication, dose, frequency, duration, and prescriber cadre. World Health Organization prescribing indicators were applied to evaluate rational use. Results showed that antibiotics were prescribed in 62.4 percent of encounters, substantially exceeding the WHO recommended benchmark of 20 to 26 percent. Amoxicillin-clavulanate and metronidazole were the most frequently prescribed agents, accounting for 34.7 percent and 18.2 percent of antibiotic prescriptions respectively. Prescribing by generic name occurred in only 41.3 percent of cases. Indications were documented in fewer than 30 percent of prescriptions, raising concerns about clinical justification. Fluoroquinolone use was notably high for uncomplicated urinary tract infections, contrary to current guideline recommendations. The study concludes that antibiotic prescribing at the study site deviates significantly from evidence-based guidelines and WHO benchmarks. Recommendations include the implementation of an antimicrobial stewardship programme, mandatory indication documentation, and prescriber education interventions targeted at rationalising antibiotic use across outpatient services.

Keywords: antibiotic prescribing, antimicrobial stewardship, rational drug use, Kano State, WHO prescribing indicators