A retrospective Evaluation of Antibacterials Used in the Management of Diabetics in a Tertiary Hospital in South-western Nigeria

Abstract

Abstract:Objective: Co-medication with antibacterials is often necessary in the management of diabetic patients. There is a constant need to evaluate the use of these antibacterials to improve therapeutic outcomes and to avoid practices that could possibly increase the emergence of antimicrobial resistance. The aim of this study was to evaluate the utilization of antibacterials in the diabetic clinic of a Nigerian tertiary hospital. Methods: A retrospective evaluation and analysis of patients' case notes written by physicians in the diabetic clinic over a three-year period (January, 2008-December, 2010) was conducted. The case notes were the individual medical records for 150 different hospitalized diabetic patients with infection as co-indication. Data was collected using a WHO instrument for studies of rational drug use. Results: Descriptive statistics such as mean, frequency, percentages and standard deviation were used to analyze categorical data obtained from the demographic variables. Fisher exact test and chi square test were employed to determine whether there were statistically significant differences or associations between mean values of antibacterial prescription pattern and attendant dosage errors. (P =/< 0.05 was accepted as significant). Comparing the mean number of antibacterial drugs in each prescription yearly yielded a mean of 1.32 in 2008, 1.37 in 2009 and 1.67 in 2010, indicating that there was no statistically significant difference. Antibacterials were used to manage complications often seen in the diabetic patient, including; diabetic foot gangrene, injection abscess, septiceamia, diabetic foot ulcer, vaginal yeast infection, amongst others. Conclusions: The majority of prescriptions met the criteria for compliance with the hospital's drug use protocol. The few instances of non-compliance with the hospital's antibiotic drug use protocol may indicate the need for continuing education, especially for the less experienced prescribers.