Assessment of Antimicrobial Stewardship Program Implementation in a Tertiary Hospital in Ilorin, Kwara State

Antimicrobial stewardship programs (ASPs) are recognized as a cornerstone intervention for combating antibiotic resistance, yet their implementation in Nigerian tertiary hospitals remains inconsistent and under-evaluated. This descriptive evaluative study assessed the level of ASP implementation at the University of Ilorin Teaching Hospital (UITH), Ilorin, Kwara State, in the North Central geopolitical zone of Nigeria. A structured assessment tool based on the WHO AWaRe framework and the Center for Disease Control Core Elements of Hospital Antibiotic Stewardship was administered to clinical pharmacists, infectious disease physicians, and medical microbiologists at the facility. Antibiotic prescribing records for 300 admitted patients across three wards were reviewed for compliance with empirical therapy guidelines. Antibiotic consumption data from the hospital pharmacy were analyzed. The assessment revealed that only four of seven WHO core ASP elements were partially operationalized. No formal antibiotic formulary restriction policy was in place. Culture-directed therapy was used in only 21.3 percent of reviewed prescriptions, despite available laboratory support. Broad-spectrum antibiotics including carbapenems and third-generation cephalosporins were prescribed empirically in 47.6 percent of cases. The study recommends formal ASP committee establishment, antibiotic prescribing restriction policies, compulsory culture sampling before initiation of therapy, and ASP training for all prescribing clinicians at UITH Ilorin. Keywords: antimicrobial stewardship, antibiotic resistance, UITH Ilorin, prescribing practices, AWaRe.