Abstract

This study reportedly investigated antimicrobial prescribing patterns and stewardship practices in primary healthcare facilities in Nigeria, with the goal of assessing adherence to treatment guidelines and identifying factors influencing rational antibiotic use. A cross-sectional observational design was reportedly employed, combining simulated prescription audit data for 2,000 outpatient prescriptions across 10 facilities with survey responses from 120 prescribers. The results reportedly indicated that broad-spectrum antibiotics were prescribed in 45% of cases, while guideline-compliant prescriptions accounted for only 20%. Urban facilities reportedly demonstrated higher compliance (28%) than semi-urban facilities (18%), a statistically significant difference. Prescriber Knowledge-Attitude-Practice (KAP) assessments revealed moderate knowledge (mean score 3.8/5), positive attitudes toward stewardship (4.0/5), but suboptimal practices (2.9/5). Correlation analyses reportedly confirmed that perceived behavioral control, subjective norms, and intention, as proposed by the Theory of Planned Behavior, were significantly associated with adherence to guidelines (r = 0.48–0.66, p < 0.001). The study reportedly concluded that tailored antimicrobial stewardship programs, including education, guideline dissemination, audit-feedback mechanisms, and patient awareness initiatives, could improve rational prescribing, mitigate resistance, and enhance patient outcomes in low-resource primary healthcare settings.