RESEARCH ARTICLE Open Access Antibiotic use among hospitalized patients in northern Nigeria: a multicenter point- prevalence survey Usman Abubakar Abstract Background: The evaluation of antibiotic use among hospitalized patients is a primary step required to design antibiotic stewardship intervention. There is paucity of data describing antibiotic use in hospitals across Northern Nigeria. This study evaluates the prevalence and indications for antibiotic use among inpatients in three acute care hospitals. Methods: A point-prevalence survey was conducted among patients in the wards before or at 8.00 a.m. on the day of the survey, using the point-prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals protocol. The survey was conducted between April and May 2019. The medical records of the patients were reviewed by a clinical pharmacist with the support of physicians and nurses. Results: Overall, 80.1% (257/321) of the patients used at least one antibiotic on the day of the survey. The prevalence of antibiotic use ranged from 72.9% in obstetrics and gynecology to 94.6% in pediatric medical specialty. Community acquired infections (38.7%) and surgical antibiotic prophylaxis (22.5%) were the most common indications. Surgical antibiotic prophylaxis was used or scheduled to be used for more than a day in all the cases. Metronidazole (30.5%), ciprofloxacin (17.1%), ceftriaxone (16.8%), amoxicillin-clavulanate (12.5%) and gentamicin (11.8%) were the most commonly prescribed antibiotics. Overall, broad spectrum antibiotics represented one-third of all the prescriptions. The change of initial antibiotic prescription was reported in one-third of the patients and the reasons include a switch to oral antibiotic (28.5%), escalation (4.5%) and de-escalation (3.6%). Of the 257 patients with an antibiotic prescription, 6.2% had redundant antibiotic combinations. Conclusion: The prevalence of antibiotic use was high with one in three prescriptions having a broad spectrum antibiotic. Prolonged use of surgical antibiotic prophylaxis and redundant antibiotic combination were observed. Antimicrobial stewardship interventions are recommended in order to reduce the use of antibiotics and promote appropriate antibiotics prescribing. Keywords: Antibiotic use, Point-prevalence, Acute care hospitals, Northern Nigeria, Antibiotic stewardship, Redundant antibiotic combination Background Globally, antimicrobial resistance has become a threat to public health security [1]. Antimicrobial resistance threatens the treatment of infections as well as advanced medical operations including surgery, dialysis, chemotherapy and organ transplant which rely on the availability of effective antibiotics. In addition, antimicrobial resistance is associated with morbidity, mortality and healthcare costs [2, 3]. The inappropriate use of antibiotic contributes to the emergence and spread of antimicrobial resistance [1]. Available evi- dence suggests that 20–50% of antibiotic prescription in the hospital is inappropriate [2]. Thus, antimicrobial stewardship is one of the strategies used to tackle the current antibiotic resistance crisis [1]. The antimicrobial stewardship program needs to be guided by data describing the prevalence and indications for antibiotic use in various clinical settings. Point-prevalence survey is increasingly been used to monitor antibiotic prescribing patterns in acute and long- term healthcare facilities. This design has been found to © The Author(s). 2020 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Correspondence: pharmumma2@gmail.com Pharmacy Department, Ibrahim Badamasi Babangida (IBB) Specialist Hospital, Minna, Niger, Nigeria Abubakar BMC Infectious Diseases (2020) 20:86 https://doi.org/10.1186/s12879-020-4815-4