Evaluation of Antibiotic Dispensing Practices by Patent Medicine Vendors in Rural Communities of Niger State

Patent medicine vendors (PMVs) are the primary point of first-contact healthcare for millions of Nigerians in rural areas, yet their antibiotic dispensing practices contribute significantly to inappropriate antibiotic use and resistance selection. This study evaluates antibiotic dispensing practices among PMVs in rural communities of Niger State, North Central Nigeria, covering 60 PMVs in Bida, Suleja, and Lavun local government areas. A simulated client approach combined with direct interviews and structured questionnaires assessed PMV knowledge of antibiotic resistance, prescription requirements, and actual dispensing behaviours for three standardised case scenarios: cough, diarrhoea, and wound infection. Antibiotics were dispensed without prescription in 85 percent of simulated client encounters. Amoxicillin and cotrimoxazole were the most commonly dispensed agents across all three scenarios, often at incorrect doses or durations. Knowledge of antibiotic resistance was inadequate in 70 percent of PMVs, and only 18 percent correctly identified prescription requirements for antibiotics under Nigerian law. The study identifies PMV antibiotic dispensing in Niger State as a significant AMR driver and recommends compulsory PMV training in antibiotic stewardship, regulatory enforcement by NAFDAC and the State Ministry of Health, and community sensitisation campaigns on appropriate antibiotic use. Keywords: patent medicine vendor, antibiotic dispensing, antimicrobial resistance, Niger State, self-medication