Developing a Hospital Drug Policy Framework for Rational Antibiotic Use in Gombe State

Hospital drug policies are essential governance instruments for promoting rational antibiotic use, yet many hospitals in Gombe State, North East Nigeria, lack formal drug policies or antimicrobial use guidelines. This study developed a hospital drug policy framework for rational antibiotic use applicable to secondary and tertiary hospitals in Gombe State. A policy development methodology incorporating facility antibiotic use audit, stakeholder interviews, and policy review was adopted. A six-month antibiotic point prevalence survey across four hospitals in Gombe metropolis identified an antibiotic prescribing rate of 79.3 percent, with broad-spectrum agents used empirically in 68.4 percent of cases without microbiological justification. Review of hospital drug committee records showed inactive committees in 75 percent of hospitals and absent antibiotic formularies in 62.5 percent. Interviews with 30 prescribers, pharmacists, and hospital administrators identified key enablers and barriers to policy implementation. The developed framework includes five policy pillars: hospital formulary committee structures and responsibilities, antibiotic formulary with an approved list and reserve categories, mandatory diagnostic and prescribing documentation standards, pharmacy antibiotic dispensing controls, and prescriber audit and feedback mechanisms. A model drug policy document ready for customisation is provided. Expert panel review by nine hospital pharmacy and infectious disease specialists validated the framework and confirmed its adaptability across facility levels. The study recommends the Gombe State Ministry of Health mandate all public hospitals to adopt and implement the framework within 24 months.

Keywords: hospital drug policy, rational antibiotic use, Gombe State, antimicrobial stewardship, North East Nigeria