Evaluation of Antibiotic Prescribing Practices Among Oral and Maxillofacial Surgeons in Teaching Hospitals in South West Nigeria

Antibiotic stewardship has become a global priority in the context of rising antimicrobial resistance, and oral and maxillofacial surgery departments are recognized as significant prescribers of antibiotics in dental clinical practice. This study evaluates the antibiotic prescribing patterns, adherence to evidence-based guidelines, and awareness of antimicrobial resistance among oral and maxillofacial surgeons practicing in teaching hospitals across the South West geopolitical zone of Nigeria. A cross-sectional survey was conducted among 65 consultants and senior resident doctors at five teaching hospitals using a validated structured questionnaire and retrospective prescription audit covering 500 patient records from 2022 to 2024. Assessment domains include drug selection, dosing, duration of prescription, prophylactic versus therapeutic use, and consultation of prescribing guidelines. Results reveal that amoxicillin-clavulanic acid and metronidazole are the most prescribed agents, with prophylactic antibiotics frequently extended beyond the recommended 24-hour period. Only 38% of respondents reported consulting any formal prescribing guideline in the past year, and awareness of local antibiogram data was poor. The study identifies a significant gap between recommended and actual prescribing practices. Recommendations include the development of department-specific antibiotic prescribing protocols, mandatory antimicrobial resistance training for all surgical residents, and quarterly prescription audits in oral surgery units across South West Nigeria. Keywords: antibiotic prescribing, antimicrobial resistance, oral surgery, stewardship, South West Nigeria.