Implementing Antimicrobial Stewardship Program in Pediatrics Across Six Hospitals in Six States in Nigeria: Needs Assessment

Antimicrobial resistance (AMR) is the ability of microorganisms to withstand treatment with antimicrobial agents. Antimicrobial use in children tends to be higher than in adults, especially in developing countries such as Nigeria. In 2017, the percentage of antibiotics prescribed per patient encounter ranged from 26.8% to 71.1 with the highest proportion reported among children under five years of age, underscoring the need for AMS in pediatrics in Nigeria. A review of the literature on AMS in pediatrics across Nigeria show scanty studies. In view of this, the Centre for Initiative and Development (CFID) in collaboration with Nigeria Centre for Disease Control (NCDC) through a grant from Pfizer conducted needs assessment in six healthcare facilities in six States of Nigeria. This was a hospital based cross sectional study conducted using well-structured questionnaire. The structured tools were administered to key hospital management in pediatrics department and data was analyzed using simple percentages. The study recorded low pediatrics AMS structures across all the six hospitals in six states. Results show that all the six hospitals do not produce antibiogram, Five hospitals 5(83.3%) do not have formal organizational structure for antimicrobial stewardship in pediatrics, most hospitals do not have formulary. Results also show that most hospitals do not have specific clinical guidelines for management of common infectious diseases in pediatrics. This reflects that pediatrics AMS practice is still in its infancy across hospitals in Nigeria. Findings from this study identifies useful drivers that will help to effectively implement pediatrics AMS in Nigeria. This study therefore, calls for urgent need of implementing antimicrobial stewardship in pediatrics across Nigeria which will be instrumental in spurring behavioral change towards rational dispensing and use of antibiotics in pediatrics and ultimately contribute towards reducing the risk of antimicrobial resistance development and spread of resistant bugs, improve pediatrics patient health outcomes and preserve the effectiveness of antibiotic therapy in pediatrics age groups.