Patterns of Antibiotic Prescription and Sales in the Buea Health District, Cameroon: Implications for Rational Use and Antimicrobial Resistance Control

Abstract

Aims: Antibiotic resistance is an escalating global health threat, exacerbated by the irrational use of antibiotics. Identifying the most prescribed and sold antibiotics in the Buea Health District offers a comprehensive yet focused approach to understanding local antibiotic use and consumption. Study Design: Cross-sectional study. Place and Duration of Study: Buea Health District of South West Region, Cameroon, between December 2024 and July 2025. Methodology: Information on most prescribed and most sold antibiotics were gotten from prescribing medical doctors and drug vendors respectively in the Buea Health district by use of a questionnaire. Numeric variables were summarized using means and standard deviations. Categorical variables were described using frequencies and percentages. A P-value of <0.05 was considered statistically significant for pearson chi square test. Results: Among the 66 medical doctors (mean age: 33.59±7.7 years) enrolled, 56.1%, 25.8%, 24.2% admitted that ceftriaxone, amoxicillin-clavulanic acid and metronidazole were their first, second and third most prescribed antibiotics respectively. Medical doctors with > 5 years of experience were significantly more likely (χ² [P-value]: 4.15 [0.042]) to choose ceftriaxone as their first-choice antibiotic (72 %) as compared to those with ≤ 5 years (46.3 %). Out of the 132 drug vendors enrolled, 54 (40.9%), 40 (30.3%) and 41 (31.1%) reported ceftriaxone, doxycycline and azithromycin, as their first, second and third most sold antibiotic respectively. Ceftriaxone was identified as both the most prescribed (56.1%) and most sold (40.9%) antibiotic. Conclusion: Ceftriaxone was identified as both the most prescribed (56.1%) and most sold (40.9%) antibiotic. The Public health sector should ensure that WATCH antibiotics like ceftriaxone are prescribed appropriately. In order to maximize the chances of having the three most prescribed antibiotics being the same as the three most sold, it is crucial to regulate over-the-counter sales and address self-medication by improving public health education.