Antibiotic Prescribing Behaviour Among Different Healthcare Cadres: Evidence from Primary Health Care Facilities in Osogbo, Nigeria
Abstract
Background: Inappropriate antibiotic prescribing in primary healthcare settings is a major driver of antimicrobial resistance , particularly in low- and middle-income countries. In Osogbo Local Government Area, Osun State, Nigeria, primary health centres serve as the primary entry point for infectious disease management, yet prescribing practices often deviate from evidence- based guidelines due to systemic constraints. Objective: This review synthesises evidence on antibiotic prescribing behaviours among healthcare cadres in primary care facilities in Osogbo, Nigeria, examining prevalence, determinants, impacts, and existing interventions. Findings: Global outpatient antibiotic prescribing prevalence is 34.3%, with low-income economies reporting 67.5%. In Osun State, antibiotic use among hospitalised patients is 76.6%, with 96.5% of prescriptions being empirical and 94.8% of surgical prophylaxis exceeding 24 hours. Key determinants include provider knowledge gaps (only 22.3% of Nigerian physicians demonstrate adequate AMR knowledge), institutional factors (lack of operational policies, drug availability issues, and pharmaceutical marketing pressure), and patient-related pressures (58.3% of prescribers cite patient insistence). Consequences include adverse drug events, increased healthcare costs (resistant infections cost 287% more to manage), and escalating AMR—currently causing 1.27 million direct deaths annually worldwide. Conclusion: Inappropriate antibiotic prescribing in Osogbo's primary health centres is pervasive, driven by multifactorial barriers. Effective interventions require context-specific strategies, including provider education, audit and feedback systems, clinical decision support tools, and strengthened regulatory enforcement.
Keywords
Antibiotic prescribingantimicrobial resistanceprimary healthcareNigeriaOsogbostewardship. Word Count: 227
References
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