Public health experts have decried the high prevalence of antimicrobial resistance (AMR) in Nigeria, identifying it as a significant factor contributing to morbidity and mortality rates. They emphasise the need for collective efforts in tackling the growing threat, warning that failure to do so could further cripple the country’s healthcare system.
The experts also highlighted the responsibility of hospitals and healthcare practitioners in addressing this persistent public health challenge. They insist that healthcare professionals must desist from the irrational prescription and administration of antibiotics, as misuse is a major driver of AMR. Additionally, hospitals have a duty to educate patients on the dangers of antibiotic misuse and abuse. They further recommended the implementation of Antimicrobial Stewardship Programmes (ASP) in hospitals as a key strategy for promoting the rational use of antibiotics and curbing AMR.
In separate interviews with Pharmanews, public health experts, Prof. Stella Smith, director of research at the Nigerian Institute of Medical Research (NIMR), Yaba, Lagos, and Dr Kingsley Chiedu Amibor, director of pharmaceutical services at the Federal Medical Centre, Asaba, discussed the havoc AMR has wreaked on Nigeria’s healthcare system and how patients can be protected from this silent killer.
Tracing the root cause of AMR, Smith, a professor of Microbiology at Mountain Top University, identified the irrational prescription of antibiotics as a major reason for the high burden in the country. She supported her argument with findings from a 2024 World Health Organisation (WHO) report on the COVID-19 pandemic, which revealed that only 8 per cent of COVID-19 patients in Nigeria had a bacterial co-infection, yet 75 per cent were prescribed antibiotics.
According to Smith, “During the COVID-19 pandemic in 2024, WHO reported that only 8 per cent of patients had bacterial co-infections. We know that COVID-19 is a viral infection. But 8 per cent had bacterial co-infections.
“But do you know what? 75 per cent of patients were prescribed antibiotics. They were like, ‘Okay, just in case it’s a bacterial infection.’ And that’s one of the major problems we have in terms of antimicrobial resistance—the misuse and abuse of antibiotics and the lack of diagnostic capabilities.”
The professor further condemned the irrational use of antibiotics by healthcare practitioners, citing another study conducted in Nigeria.
“Another example from Nigeria is a report from a tertiary hospital where they examined the number of patients prescribed antibiotics. It turned out that fewer than 25 per cent of patients who visited the hospital actually had bacterial infections, and an even smaller percentage underwent antimicrobial susceptibility tests.”
She emphasised the urgent need for healthcare authorities to take action in saving the lives of over 700,000 people who die annually due to AMR. She urged practitioners to adhere to professional guidelines on antibiotic prescription while maintaining a hygienic environment in healthcare facilities.
Amibor, a consultant clinical pharmacist, corroborated Smith’s views, citing findings from a recent survey which showed that fewer than 40 per cent of patients in the public sector and fewer than 30 per cent in the private sector are treated in accordance with standard antibiotic treatment guidelines. This, he noted, underscores the urgent need for a reorientation towards the rational use of antibiotics.
He advocated a multidisciplinary, collaborative, and regulatory approach as the best model for combating AMR. He urged hospitals to insist on rational prescription and use of antimicrobials, ensure continuous stocking of antibiotics to discourage patients from seeking treatment from unqualified individuals, and ultimately curb AMR.
He said: “Hospitals should improve hand hygiene as well as infection prevention and control (IPC) practices. Medical laboratory departments should also maintain records of antibiotic resistance patterns and promptly update the hospital community when resistant strains of microorganisms are observed as part of early detection and control measures.”
According to Amibor, strategies for optimising antimicrobial use include restricting the use of certain antimicrobials to prevent overuse, reviewing antimicrobial prescriptions and providing feedback to prescribers, developing antimicrobial guidelines, and equipping healthcare professionals with the necessary knowledge and skills to prescribe antimicrobials appropriately.
He also stressed the importance of surveillance of antimicrobial resistance to monitor resistance patterns and guide treatment decisions, as well as infection prevention and control measures to reduce infections and, consequently, the need for antimicrobials.
The consultant clinical pharmacist also highlighted the multidisciplinary roles of healthcare team members in containing the AMR pandemic. He stressed that in addition to providing direct patient care, physicians must comply with local infection control and antibiotic use policies. Furthermore, timely notification of resistant cases to IPC units is essential.
Since nurses and other healthcare providers are in direct contact with patients, he warned that they could either help control or worsen the spread of infections.
According to him, “Educating nurses and healthcare providers about AMR and aseptic practices may help control the spread of infections. The use of personal protective equipment (PPE) by healthcare workers will help protect them and their patients from acquiring or spreading infections, thereby reducing AMR.”
Amibor described pharmacists as playing a crucial role in combating AMR: “Educating patients on the proper use of antibiotics will go a long way in curbing AMR. Patients should be counselled to complete their prescribed medications, avoid sharing antibiotics—especially among children—and refrain from discontinuing medication once they start feeling better.”
