Antibiotics prescription pattern and determinants of utilization in the national health insurance scheme at a Tertiary Hospital in Nigeria

Abstract

Background: Subsidizing the cost of medicines through insurance schemes increases consumption of medicines and may contribute to irrational use of antibiotics. Objectives: To describe the systemic antibiotics prescriptions patterns and analyze the determinants of their utilization in the National Health insurance Scheme (NHIS).Methods: Established WHO guideline was followed to conduct this cross-sectional retrospective study at University of Nigeria Teaching Hospital, Nigeria. Data were collected from randomly sampled prescription sheets of one year duration. Logistic regression analysis was performed to determine the predictors of antibiotics prescriptions.Results: The results are based on 802 sampled out-patients NHIS prescriptions. Average number of medicines per encounter was 4.0 ± 1.8, whereas 46.9% of antibiotics were prescribed by generic name. Penicillins (most frequently amoxicillin/clavulanate), and nitroimidazole (most frequently metronidazole) were the most commonly prescribed antibiotics with percentage share of 43.3% and 22.2%. Being <5 years old, and taking more than 4 medicines (OR 2.20, 95% CI 1.37-3.55) were the factors associated with the highest risk of antibiotics exposure.Conclusion: There were poly-pharmacy, and non-adherence to generic antibiotic prescriptions. Penicillins (amoxicillin/clavulanate) were the most commonly prescribed antibiotic class. Being < 5 years old, and taking more than 4 medicines were significant predictors of antibiotics exposure.Keywords: Antibiotics; national health insurance scheme; Nigeria; poly-pharmacy; prescription.

Occurrence and risk assessment of selected pharmaceuticals in water and sediments of Usuma Dam, Abuja, Nigeria

“…This may be attributed to their widespread use and frequent prescription by health care providers. Metronidazole, Ciprofloxacin and Amoxycillin are the commonly prescribed antibiotics in Nigeria [56,57]. Ciprofloxacin has been detected at lower concentration in Ugandan Lake Victoria at 91% frequency [23].…”

Socio-Demographics of Patients and Antibiotic Prescription Pattern in a Community Health Facility in Lagos

“…This finding was corroborated by Ngwaiet al(2020) who found that antibiotic encounter was higher in the 10 years and below age group than among older population. However, Okoro, Nmeka and Erah (2019) finding showed that patients less than 5 years had higher antibiotic encounter than older population. There is no gender disparity in the use of antibiotics as differences in antibiotics encounter were not statistically significant (X 2 = 0.530, df= 1, p>0.05).…”

“…The odds of having antibiotics in the prescription reduces by 3% for every unit increase in age (OR = 0.97; 95% CI: 0.97, 0.98). In Nasarawa state, North-Central Nigeria, a descriptive retrospective cross-sectional study involving 2800 cases between 2008 and 2018 showed that antibiotics prescription was highest in the 10 years and below age category (67%) and lowest for those greater than 50 years (Ngwaiet al, 2020).However, a crosssectional study of 802 National Health Insurance Scheme (NHIS) prescriptions from University of Nigeria Teaching Hospital showed that patients less than 5years has highest risks of antibiotic exposure (Okoro, Nmeka, &Erah, 2019).…”

“…However, a cross-sectional study involving 600 encounters in six community pharmacies in Asmara, Eritrea found that males were one and half times more likely to encounter antibiotics exposure than females (AOR: 1.57, 95%CI: 1.10-2.24) (Amahaet al, 2019). Study from the tertiary health institution South-East Nigeria, that interrogated 802 NHIS prescriptions found that females (57.3%) encountered more antibiotics than males (Okoro, Nmeka, &Erah, 2019).…”

Editorial

“…The papers on bacterial infections include antibiotic prescriptions, self-medication, diagnosis and neonatal sepsis. Hence from a tertiary hospital in Nigeria, we have a paper on antibiotics prescription and determinants of utilization 7 , while from Indonesia we have a report on self-medication profile for diarrhea with traditional medication 8 . The paper on the role of C-reactive protein in the diagnosis of meningitis 9 and the two papers on neonatal sepsis 10,11 shine some light on infections in children.…”