Evaluation of Antimicrobial Use in the Surgical Ward of a Federal Teaching Hospital in Benin City, South South Nigeria

Background: Inappropriate perioperative and postoperative antimicrobial use in surgical wards is a major contributor to antimicrobial resistance and increased healthcare costs. Evaluating prescribing patterns against evidence-based surgical prophylaxis guidelines is essential for stewardship. This study evaluated antimicrobial prescribing in the surgical ward of the University of Benin Teaching Hospital, Edo State. Methods: A prospective observational study was conducted over three months. Antimicrobial prescriptions for 220 surgical patients were reviewed for agent selection, duration, timing of prophylactic dosing, and compliance with the hospital's surgical antimicrobial prophylaxis protocol. Results: Antimicrobial prophylaxis was administered preoperatively in only 47 percent of eligible surgical cases. Postoperative antibiotic continuation exceeded 24 hours in 78 percent of prophylaxis cases, far beyond guideline recommendations. Metronidazole and ceftriaxone were the most commonly used agents. Culture-guided therapy was employed in fewer than 30 percent of therapeutic cases. Conclusion: Antimicrobial use in the UBTH surgical ward shows significant deviations from best practice. An antimicrobial stewardship programme with surgical-specific protocols is urgently needed to reduce unnecessary antibiotic exposure and resistance risk. Keywords: antimicrobial stewardship, surgical prophylaxis, prescribing patterns, Benin City, resistance