Determinants of Antibiotic Abuse and Misuse among Staff and Students in a Teaching Hospital in Nigeria – A Mixed-method Study

Background and Aim: Antimicrobial resistance resulting from antibiotic misuse is a major threat to public health in this century. This study explored the determinants of antibiotic misuse and abuse among healthcare staff in a teaching hospital setting. Materials and Methods: The sample included students and workers from a teaching hospital in South-west Nigeria. A mixed-method research was conducted, using questionnaires and interviews. Data on antibiotic misuse and abuse (frequency, classes used, and perceptions) were collected from 231 respondents (quantitative = 222, qualitative = 9). Quantitative data were analyzed using descriptive (Frequencies, percentages, and means) and inferential (Chi-square) at P < 0.05. Similarly, qualitative data were analyzed using content analysis and presented as themes. Results: Results showed that 74.0% of the respondents used antibiotics without a prescription, and commonly used antibiotics are metronidazole (28.4%), amoxicillin (18.0%), ciprofloxacin (12.6%), and ampiclox (6.8%). Results also showed that an overwhelming majority (86.9%) of the respondents had good knowledge of the causes of antibiotic resistance. Furthermore, findings showed a significant relationship between knowledge of antibiotic resistance among respondents and the status of the respondents ( P < 0.0001). In addition, the analysis of the qualitative data uncovered four interrelated themes: (i) Understanding the inappropriate use of antibiotics and the development of antibiotic resistance, (ii) Poor policy and regulation, (iii) Transforming a valid reason into an opportunity for misusing antibiotics, and (iv) Health education is the key. Conclusion: This study concluded that antibiotic abuse is influenced by knowledge, frequency of use, perception of resistance, necessity for use, poor regulation, and health workers’ roles. Recommendations include intensive health education and regulation to address inappropriate antibiotic use in society.