Comparative Costs of Antibacterial Usage in Sexually Transmitted Infections in a Nigerian Teaching Hospital

Purpose: To evaluate the cost of antibacterial usage to patients in a tertiary health facility in Nigeria.
Methods: Drug utilization evaluation was carried out retrospectively among patients with sexually transmitted infections (STIs) over a one-year period between 2005 and 2006 in Lagos University Teaching Hospital (LUTH), Nigeria. Case notes numbering 230 and containing 317 prescriptions were sampled consecutively with the aid of diagnostic coding cards. Relevant data including case demographics, diagnosis, prescribed drugs, and dosages were extracted and the associated costs analysed.
Results: A majority of the patients (82.3 %) were youths aged 21 -40 years. Higher prevalence was observed among male patients (70.2 %). The proportion of drugs prescribed in generic and branded names were 82.1 and 17.9 %, respectively. Total number of antibacterial doses was 7284 at a total cost of NGN239,420.00 (US$1,841.69). Average antibacterial cost per patient was NGN1,040.96 (US$8.00). Quinolones were the most widely prescribed class of antibacterial agents (31.1 % of cases) at a cost of NGN81,646.00 (US$628.05) representing 34.1% of the total antibacterial cost to patients.
Conclusion: This study indicates that antibacterial cost was high, relative to the purchasing power of the local populace, a large proportion of whom live below the poverty line (US$1.00 per day). Furthermore, a greater proportion of the antibacterial cost was due to a few agents, the use of which should be evidence-based and closely monitored.

Keywords
Antibacterial therapy, Cost, Antibacterial utilization, Infectious diseases.