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Background: Indiscriminate use of antimicrobials is threatening their effective use owing to resistance. This study aims to describe the pattern and quality of antimicrobials prescribing at the University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria (UITH) using the five-year data from the Global-Point Prevalence Surveillance (G-PPS). Method: G-PPS, a web-based software, was used among inpatients from 2017 to 2022 according to the protocol designed at the University of Antwerp, Belgium. Data collected using the standardised Email; fadeyi.a@unilorin.edu.ng questionnaire were inputted, cleaned and submitted with the software which gives auto-analysed results immediately. Result: A total of 783 patients and 1281 antimicrobial prescriptions were studied. The 5-year mean overall antimicrobial prevalence was 79.8% and 71.6% for Paediatric and Adult patient population respectively. Overall, there were more intravenous prescriptions (75.9%) than other routes. Polypharmacy with multiple antibiotics use for a single diagnosis (57.1%) and patient (57.6%) were prevalent. The "Access" (51.0%) category of antimicrobials were equally often prescribed as the "Watch" (48.2%) with few "Not Recommended" (0.8%). Most prescriptions were empirical. Indication for antibiotics prescription, and the stop/review date were poorly documented. Antimicrobial prescribing guidelines, such as antibiogram, were not available hence the failure of compliance to any guideline. Conclusion: Antimicrobial prevalence in this study was high, and the quality of prescribing was also unsatisfactory. This requires intervention at many levels, focusing on prescribers, hospital administrators, healthcare policy makers and government. Failure of modulating to ensure rational antimicrobial prescribing may constitute a threat of returning to the casualties of the 'Pre-antimicrobialEra'. [ABSTRACT FROM AUTHOR]

Introduction: Inappropriate use of antibiotics for childhood illnesses, especially for non-bacterial infections, contributes to the development of antimicrobial resistance (AMR). Globally, implementation of antimicrobial stewardship programme (ASP) in all healthcare institutions is a strategic intervention to improve the appropriate use of antibiotics, reduce antimicrobial consumption and tackle AMR. The aim of this study was to evaluate the effect of prospective audit with intervention and feedback as an antimicrobial stewardship strategy on antimicrobial use, evaluate prescribers' response to recommendations and determine the rate of AMR in the Paediatrics Department of the Lagos University Teaching Hospital, Nigeria., Materials and Methods: This was an implementation study of the paediatrics Antimicrobial Stewardship Programme (ASP) over a period of 6 months. It was initiated with a point prevalence survey (PPS) to describe the antimicrobial prescribing patterns and followed by prospective audit with interventions and feedback using an antimicrobial checklist and the existing antimicrobial guidelines in the Paediatrics Department., Results: The antibiotic prescribing prevalence was high (79.9%) at baseline PPS with 139 patients on admission, of which 111 (79.9%) were treated with 202 antibiotic therapies. Over the 6 months of study, 582 patients on 1146 antimicrobial therapies were audited. Compliance with departmental guidelines was 58.1% of the total 1146 prescriptions audited (n = 666), making the antimicrobial prescription inappropriate in 41.9% (n = 480) of therapies. The most recommended intervention for inappropriateness was 'change antibiotics' 48.8% (n = 234), followed by 'stop antibiotics' 26% (n = 125), 'reduce the number of antibiotics' 19.6% (n = 194) and 'de-escalate' 2.4% (n = 11). Agreement with ASP interventions occurred in 193 (40.2%) cases, and the least agreed intervention was 'stop antibiotics' (n = 40, 32%). However, there was a steady increase in compliance rates with ASP interventions over the 6 months of period study, which was statically significant (χ 2: 30.005; P = 0.001)., Conclusion: ASP prospective audit with intervention and feedback was of significant benefit in improving compliance with antimicrobial guidelines, thereby improving antimicrobial therapy in the Paediatrics Department of LUTH, Nigeria.

Background: Invasive candidiasis has been identified globally as a major cause of morbidity and mortality in neonatal intensive care units (NICU). Systemic candidiasis presents like bacterial sepsis and can involve multiple organs., Objective: The objective of this study was to determine the prevalence of Candida infection in a NICU at a tertiary hospital in Nigeria and to identify its associated risk factors., Materials and Methods: The study was a retrospective descriptive study of all cases of culture-proven invasive Candida infection (ICI) in neonates admitted to the NICU over a 4-year period. The study participants were identified from microbiology records of all neonates with a positive Candida culture. Medical records of identified neonates were also reviewed, and relevant information obtained., Results: Over the 4 years, 2712 newborns were admitted to the NICU. From these, 1182 various clinical samples were collected from babies with features of sepsis and processed in the medical microbiology laboratory. Twenty-seven (2.3%) of the cultures yielded Candida organisms; fifteen of the Candida cultures were from male infants with a male:female ratio of 1.3:1. Bloodstream infection was the most frequent ICI seen in preterm babies (seven [58.3%] out of 12 babies with ICI). Nearly, all (91.7%) affected preterm infants with ICI were <1500 g in weight. All were exposed to invasive procedures and broad-spectrum antibiotics. The case fatality rate among those with ICI was 18.5%., Conclusion: There was a significant prevalence of invasive candidiasis in high-risk newborns and the incidence increases with increased practices in risk factors such as invasive procedures and antibiotic use and lower gestational age babies with very low birth weight.