Comparative analysis of antibiotics prescription pattern and in vitro antibiotic evaluation of pregnant women attending antenatal in a tertiary hospital in anambra state, Nigeria

Abstract

Antibiotic prescription pattern is described as a written directive from the physician to the dispenser on how the medication should be administered in order to ensure infection controlled. The aim of this study was to determine the antibiotics prescription pattern among pregnant women attending antenatal care in the Teaching Hospital for over an eighteen months period and a comparative in vitro evaluation of the mostly prescribed antibiotics during antenatal care was also done. Fifty urine samples were collected from pregnant women visiting the same hospital for comparative analysis. Early morning midstream urine samples collected from the pregnant women were cultured on MacConkey and blood agar. The biochemical tests include urease, oxidase, indole, catalase, citrate tests and gram staining. The antibiotic susceptibility pattern was also determined. A total of three hundred and four (304) patient prescriptions were evaluated, antibiotics prescribed were amoxicillin 93(27%), ampicillin/cloxacillin 15(4%), amoxicillin-Clavulanate 83(24%), ampicillin 3(0.9%), cefpodoxime 11(3.2%), cefixime 5(1.4%), cefuroxime 10(2.9%), erythromycin 28(8.2%), ofloxacin 7(2.0%), levofloxacin 11(3.2%), ciprofloxacin 6(1.7%), clarithromycin 1(0.3%), azithromycin 10(2.9%), clindamycin 1(0.3%), nitrofurantoin 21(6.1%) and metronidazole 39(11.3%). For the in vitro studies, seventy one (71) isolates were identified as follows E.coli 17 (24%) followed by Klebsiella spp 14(20%), Stapyhlococcus spp 13(18%), Streptoccocus spp 12 (17%), Proteus spp 9(13%), and Pseudomonas spp 6 (8%). The findings of in vitro study confirmed that some of the antibiotics prescribed namely ampicillin/cloxacillin, amoxicillin/clavulanate, cefixime and cefuroxime did not provide infection control which may be due to inappropriate prescription or drug misuse.