Antibiotic Prescribing Patterns and Their Influence on Susceptibility Profiles of Uropathogens in Oyo State, South West Nigeria: A Laboratory Perspective

Inappropriate antibiotic prescribing practices drive selection pressure that increases antimicrobial resistance, with implications for the efficacy of empirical treatment regimens recommended for urinary tract infections. This study examined antibiotic prescribing patterns and their relationship to the susceptibility profiles of uropathogens at selected hospitals in Oyo State, South West Nigeria, from a medical laboratory perspective. A retrospective cross-sectional study reviewed 360 paired records consisting of urine culture results and corresponding prescription data collected from patient files and pharmacy dispensing records. Uropathogens isolated and their susceptibility profiles were extracted from laboratory registers. Prescribing patterns, including drug choice, dosing frequency, and prior antibiotic use, were correlated with resistance rates. E. coli, Klebsiella pneumoniae, and Proteus mirabilis were the predominant isolates. Resistance to co-trimoxazole exceeded 78.0%, while nitrofurantoin retained 82.4% susceptibility. Patients with prior antibiotic exposure in the preceding four weeks had significantly higher odds of harbouring resistant strains. Empirical use of fluoroquinolones was associated with escalating resistance. Self-medication with antibiotics was reported by 47.2% of patients. The study demonstrates a direct relationship between community antibiotic use and resistance patterns and recommends mandatory antibiotic stewardship implementation at hospital and community levels, integration of local antibiogram data into prescribing guidelines, and public campaigns against antibiotic self-medication in South West Nigeria. Keywords: antibiotic prescribing, antimicrobial resistance, uropathogens, stewardship, urinary tract infection