For Mrs. Grace Ugwu, a 42-year-old mother from the Gajiri community along the Abuja-Kaduna Expressway in Suleja LGA, Niger State, antibiotics were like painkillers – she took them until she felt better, then stopped.
Ugwu had been prescribed a seven-day course of antibiotics for a bacterial infection but discontinued the medication on the third day. A week later, the infection returned – this time, more severe.
“I thought the drugs had worked. I didn’t know stopping them halfway could make things worse,” she admitted from her hospital bed.
Her story is not unique. Across Nigeria, many patients misinterpret what “take exactly as prescribed” means, leading to serious health risks, including antibiotic resistance – a growing public health crisis.
The directive is meant to ensure patients adhere strictly to the dosage, timing, and duration specified by their healthcare provider. This adherence is crucial for eliminating infections and preventing bacteria from developing resistance. However, in Nigeria, various factors influence how people understand and follow this instruction.
A study in Abia State found that 46.5 per cent of residents engaged in self-medication with antibiotics, often obtaining them without prescriptions from pharmacies. This behaviour reflects a significant gap in awareness regarding the importance of completing prescribed courses.
Similarly, research conducted in Ibadan revealed that many individuals stop taking antibiotics once they feel better or when symptoms disappear rather than completing the full course. This premature discontinuation can lead to incomplete treatment, allowing bacteria to survive and evolve resistance.
A national survey further highlighted that while healthcare workers have a moderate level of awareness regarding antimicrobial resistance, this does not always translate into proper prescribing practices. Even some medical professionals underestimate the critical importance of strict adherence.
Pharm. Isa Hassan Muhammadu, a pharmacist in Kano State, encounters this issue frequently.
“Many patients tell me, ‘Pharmacist, I felt better after two days, so I stopped.’ They don’t realise that the bacteria might still be present and could become resistant to treatment,” he explained.
Muhammadu added that Nigeria has a booming informal pharmaceutical market, where antibiotics are sold over the counter without prescriptions.
“At Ogbete Market in Enugu or Sabon Gari in Kano, traders sell antibiotics to customers who ask for ‘strong drugs’ to cure everything from fevers to body pains,” he said.
Mr. Dapo Akin, a trader at Utako Market in the Federal Capital Territory, admitted that he relies on recommendations from local chemists rather than seeing a doctor.
“I just buy what the chemist recommends. Doctors are expensive and I don’t have time for hospital queues,” he said.
For some Nigerians, advice from family and friends carries more weight than a doctor’s prescription. Ms. Blessing Ojodomo, a university student, admitted that her roommate had told her to take just three capsules because the full dose was “too strong.”
In response to the rising threat of antimicrobial resistance, government agencies are beginning to take action.
The director-general of the Nigeria Centre for Disease Control (NCDC), Dr. Jide Idris recently stated that stricter regulations and monitoring of antibiotic sales are being considered to curb over-the-counter misuse.
“We are working on policies to ensure antibiotics are dispensed only with a valid prescription,” Idris noted.
He believes this move will help reduce self-medication and enforce adherence to prescribed guidelines.
Beyond the health implications, antibiotic misuse carries a significant economic cost.
Dr. Abigail Banji, a health economist, explained that as infections become more resistant, patients often require longer hospital stays and more expensive, second-line treatments.
“This not only strains individual finances but also burdens the national healthcare system,” she noted.
A recent report from a health economics research group warned that the cost of treating drug-resistant infections could escalate rapidly, diverting resources from other critical healthcare services.
To combat misinformation, some NGOs are running awareness campaigns in markets and rural areas, teaching people about antibiotic resistance and proper medication use.
Dr. Chika Okeke, a public health advocate, said they now go into communities and break the information down in local languages.
“If people don’t understand, they won’t change,” Okeke said.
Healthcare professionals also emphasise the importance of patient counseling.
According to Mrs. Nkechi Uche, a nurse at a public hospital, some hospitals now ensure that patients receive counseling before getting prescriptions.
“In my clinic, I don’t just hand out drugs – I explain why they must finish their medication,” Uche said.
Laboratory and research director at Rotan Medical Diagnostics Ltd, Dr. Akujuobi Igwe called on both the government and community leaders to launch nationwide campaigns that not only inform but also empower citizens to take charge of their health.
He emphasised that a coordinated approach – stricter regulation of antibiotic sales, public health education, and community engagement – is critical to reversing current trends.
As Nigeria battles rising antibiotic resistance, changing public perception is key.
For patients like Ugwu, the lesson came the hard way.
“Now, I take all my medication, no matter how I feel,” she said.
The question remains: How many more people must learn this lesson the hard way before real change happens? The combined efforts of the government, healthcare professionals, and community organisations may finally turn the tide against this silent epidemic.
