Antibiotic Guidelines for Critically Ill Patients in Nigeria

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Antimicrobial Stewardship

Background:

• Inappropriate antimicrobial use drives antimicrobial resistance globally.
• Antibiotic stewardship programs reduce resistance, improve patient outcomes, and offer economic benefits.
• Nigeria lacks specific antimicrobial guidelines for critically ill patients in intensive care units (ICUs).

Purpose of the Study:

• To develop evidence-based antimicrobial treatment guidelines for critically ill patients in Nigerian ICUs.
• To address the scarcity of local guidelines for managing infections in this vulnerable population.
• To promote effective antibiotic stewardship and combat antimicrobial resistance in Nigerian ICUs.

Main Methods:

• A multidisciplinary committee of 12 experts developed the guidelines.
• Recommendations were based on published data and local prospective antibiograms from three Nigerian ICUs.
• Guidelines were approved by consensus among committee members, considering drug availability.

Main Results:

• Candida albicans and Pseudomonas aeruginosa were the most common pathogens.
• Specific empiric antibiotic recommendations were established for various infections including pneumonia, skin and soft tissue infections, bloodstream infections, and urinary tract infections.
• Amikacin, colistin, polymixin B, meropenem, amoxicillin-clavulanate, ceftriaxone, piperacillin-tazobactam, fluconazole, and vancomycin were among the recommended agents based on efficacy and local resistance patterns.

Conclusions:

• Developed Nigerian-specific, evidence-based antimicrobial guidelines for critically ill patients in ICUs.
• Implementation will support learning, enhance stewardship activities, and provide a basis for future guideline updates.
• These guidelines aim to optimize antimicrobial use and improve patient care in Nigerian ICUs.