ANTIBIOTIC MISUSE AND ITS IMPACT ON THE DEVELOPMENT OF ANTIMICROBIAL RESISTANCE (AMR) IN NORTH EASTERN NIGERIA

Abstract

Antimicrobial resistance (AMR) poses a critical global public health threat, particularly in low- and middle-income countries. This descriptive cross-sectional study investigated the patterns of antibiotic misuse and its association with demographic characteristics, knowledge, awareness, attitudes, and behaviors among 423 adults in North Eastern Nigeria. The findings reveal widespread inappropriate antibiotic use, including self-medication (52.2%), incomplete courses (49.4% reported not usually completing), and sharing of antibiotics (53.4%). Self-medication and incomplete antibiotic use were significantly more prevalent among individuals aged 25–64 years, males, urban residents, and those with tertiary education. Poor antibiotic knowledge and prevalent misconceptions, such as the belief that antibiotics cure viral infections (56% of respondents), were significantly associated with higher rates of misuse. A significant number of respondents (26.0%) believed antibiotics are effective for all illnesses and engaged in self-medication. Furthermore, belief in the acceptability of sharing antibiotics (23.4%) and the safety of self-medication (15.6%) were strongly linked to misuse behaviors. Logistic regression identified self-medication (OR = 0.273, 95% CI: 0.182–0.409, p < 0.001) and sharing of antibiotics (OR = 0.431, 95% CI: 0.290–0.639, p < 0.001) as significant predictors of treatment failure. These findings underscore an urgent need for targeted public health interventions, including tailored education campaigns, stricter regulation of antibiotic sales, and promotion of the One Health approach, to curb antibiotic misuse and mitigate AMR in North Eastern Nigeria.