Antibiotic Prescribing Patterns in Primary Healthcare Centres in Enugu State, South East Nigeria

Background: Irrational antibiotic prescribing remains a critical driver of antimicrobial resistance in low- and middle-income countries. In Nigeria, primary healthcare centres often operate under significant resource constraints, creating environments where prescribing practices may deviate from established guidelines. This study investigates antibiotic prescribing patterns at selected primary healthcare centres in Enugu State, South East Nigeria. Methods: A retrospective cross-sectional design was employed, involving the review of 400 outpatient prescription records obtained from five primary healthcare facilities over a six-month period. Data were analysed using the World Health Organization core drug use indicators, including the average number of drugs per prescription, percentage of prescriptions with antibiotics, and percentage of drugs prescribed from the essential medicines list. Results: Preliminary findings indicate that antibiotics were present in 62 percent of all prescriptions reviewed, with penicillins and fluoroquinolones being the most frequently prescribed classes. Polypharmacy was observed in over 45 percent of prescriptions. Fewer than 30 percent of prescriptions aligned with current national treatment guidelines. Conclusion: Antibiotic prescribing in primary healthcare centres in Enugu State shows considerable deviation from evidence-based standards. These findings highlight urgent need for prescriber training, pharmacy-led interventions, and strengthened antimicrobial stewardship programmes at the primary care level. Keywords: antibiotic prescribing, antimicrobial resistance, primary healthcare, Enugu, drug use indicators