Pharmacy World and Science

, Volume 24, Issue 5, pp 188–195 | Cite as

Survey of drug use practices and antibiotic prescribing pattern at a general hospital in Nigeria

  • C.M. ChukwuaniEmail author
  • M. Onifade
  • K. Sumonu


Objective: To describe the current drug use practices at the institution, and gather baseline data, which can serve as a basis for designing an appropriate intervention to improve the drug use profile. Method: A retrospective audit of in- and out-patient prescriptions, generated during the period January–March 1999. Indicators of drug use pattern include: average number of drugs prescribed per encounter (ANDPE), average number of antibiotics prescribed per encounter (ANAPE), % encounter with antibiotics (PEA), percent of antibiotic prescriptions based on microbial sensitivity test results (MCST). Additionally, a “knowledge, attitude and practice” (KAP) survey of prescribers and dispensers was performed. Indicators of prescribing and dispensing quality include: sources of drug/prescribing information, availability and use of the hospital formulary, knowledge of the prescribing process and the adequacy of the drug supply management system.Results: A total of 9984 outpatient prescriptions and 127 in-patient case notes were audited. The total number of prescribers and dispensers surveyed were 88 and 13 respectively. The ANDPE was found to be 3.16 for out-patients and 9.7 for in-patients, ANAPE was 1.1and 2.4 for out-patients and inpatients respectively. The PEA was 50.3% for out-patients and 96.7% for in-patients. Only 4.2% of in-patient antibiotic prescriptions were based on MCST and percent encounter with switches in antimicrobial therapy was 52.1% while the average number of switches per encounter was 1.35. In 18.5% of the in-patient encounters there was evidence of drug incompatibilities. The KAP survey revealed that prescribers and dispensers in the hospital rely on different sources for their drug information needs (MIMS vs Martindale Extrapharmacoepia). None of the prescribers surveyed was able to correctly enumerate all the 4 steps involved in the prescribing process, about 25% got at least 2 steps correctly, and only 9.1% of the dispensers surveyed could accurately define a hospital formulary. The drug supply management system was found to be inadequate. Conclusion: The survey revealed that appreciable gaps in knowledge with respect to rational drug use, still exists among these cadre of healthcare professionals. The foregoing suggests an urgent need for review of current policies and systems in the hospital with the view of enhancing the drug use practices of the health providers. Specifically it is recommended that there should be an intervention program involving concerted continuing education (to influence the KAP of the various cadre of healthcare providers) and the establishment of a hospital formulary / standard treatment guidelines.

Antibiotics Drug use Nigeria Prescription audit 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    MSH (Management Science for Health). Managing for rational drug use, 2nd ed. 1997;422.Google Scholar
  2. 2.
    Zhan SK, Tang SL, Guo YD, Bloom G. Drug prescribing in rural health facilities in China: implications for service quality and cost. Trop Doct Jan 1998;28(1):42–8.Google Scholar
  3. 3.
    Taylor O, Chukwuani CM, Eniojukan JF, and Fajemirokun O. Socio-economic evaluation of parenteral antibacterial therapy in Lagos University Teaching Hospital (LUTH): results of a retrospective survey. West Afr J Pharm 1997;11(2):78–86.Google Scholar
  4. 4.
    Segede Buceta XM. Impact of various objectives related to the rational use of medication in a primary care area. Aten Primatia Mar 15 2000;25(4):236–41.Google Scholar
  5. 5.
    Castan Cameo S, Garcia Latorre FJ, Martinez Gorostiaga J, Sierra Moros MJ, Solano Bernad VM, Peral Casado A. Minizing the costs of prescription of anti-infective drugs in two areas of primary health care. Rev Esp Salud Publica 1998;72(1):33–42.PubMedGoogle Scholar
  6. 6.
    Osifo NG, Ogbuebele HU. Hospital drug use review in a developing country. Am J Hosp Pharm Jul 1981;38(7):1037–9.Google Scholar
  7. 7.
    Ohaju-Obodo JO, Isah AO, Mabadeje AFB. Prescribing pattern of clinicians in private health institutions in Edo and Delta States of Nigeria. Nig Qt J Hosp Med 1998;8(2):91–4.Google Scholar
  8. 8.
    Oviawe O, Okonokhua L, Isenalumhe A. Prescriber performance in paediatric general practice clinic of a University Teaching Hospital. W Afr J Med 1989;8:130–4.Google Scholar
  9. 9.
    Eniojukan JF, Yusuf IA. Antmicrobial therapy in Lagos University Teaching Hospital: a 2-year retrospective audit. Nig Qt J Hosp Med 1996;6(2):104–9.Google Scholar
  10. 10.
    Ezeofor TC, Ibe BC. Prescribing habits of resident doctors in the paediatric out-patient services of the University of Nigeria Teaching Hospital. Nig Med Pract 1995;29(1/2):13–5.Google Scholar
  11. 11.
    Adamson TA. Prescribing habits for psychiatric in-patient admissions in a Nigerian Psychiatric Hospital. Afr J Med Med Sci 1995;24(3):261–7.PubMedGoogle Scholar
  12. 12.
    Odusanya OO. Antibiotic prescribing at primary healthcare facilities in Lagos. J Nig Infect Control Assoc 1999;2(1):24–6.Google Scholar
  13. 13.
    Hammer JS. To prescribe or not to prescribe: on the regulation of pharmaceuticals in less developed countries. Soc Sci Med 1992;34(9):959–64.PubMedGoogle Scholar
  14. 14.
    Gram LE, Hallas J, Andersen M. Pharmacovigilance based on prescription databases. Pharmacol Toxicol 2000;86(suppl 1):13–5.PubMedGoogle Scholar
  15. 15.
    Chan RA et al. Gentamicin therapy in renal failure: a monogram for dosage. Ann Int Med 1972;76:773.PubMedGoogle Scholar
  16. 16.
    Hull JH et al. Gentamicin serum concentrations: pharmacokinetic predictions. Ann Int Med 1976;85:183.PubMedGoogle Scholar
  17. 17.
    Isah AO, Isah EC. Drug information sources utilized by junior hospital doctors in Nigeria. The Nig Post Grad Med J 1998;5(1):23–7.Google Scholar
  18. 18.
    Mabadeje AF, Akintonwa AA, Ashorobi RB. The value of implementing an essential drugs list in LUTH. Clin Pharmacol Ther 1991;50(2):121–4.PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers 2002

Authors and Affiliations

  1. 1.School of Pharmacy, College of Medicine of theUniversity of LagosLagosNigeria
  2. 2.General Hospital IkejaLagosNigeria
  3. 3.Directorate of Pharmaceutical Services Lagos State Ministry of Health AlausaLagosNigeria

Personalised recommendations