When Mrs Grace Ugwu, a 42-year-old mother from the Gajiri community along the Abuja-Kaduna Expressway in Suleja LGA, Niger, was prescribed antibiotics for a bacterial infection, she treated them like painkillers.
She took them only until she felt better, then stopping.
Ugwu explained that she had been given a seven-day course, but stopped 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.
Unfortunately, her story is far from unique.
Across Nigeria, many patients misinterpret the instruction to “take exactly as prescribed”.
This often leads to incomplete treatment and contributes to the growing public health threat of antibiotic resistance.
Health experts warn that this directive is not a mere suggestion, but an important guideline intended to ensure patients follow the exact dosage, timing, and duration prescribed by their healthcare provider.
They believe that this adherence is essential to effectively eliminate infections and prevent bacteria from developing resistance to treatment.
However, in practice, adherence in Nigeria is often undermined by various factors, including poor awareness, economic constraints, and cultural beliefs.
A 2020 study published in the International Journal of Community Medicine and Public Health revealed that 46.5 per cent of respondents in Abia State engaged in self-medication with antibiotics, frequently obtaining them from pharmacies without prescriptions.
This practice underscores a growing knowledge gap regarding the importance of completing antibiotic courses.
Similarly, research conducted at the University College Hospital in Ibadan, Oyo State, published in the Nigerian Journal of Clinical Practice found that many individuals discontinue antibiotics as soon as they feel better, rather than completing the full prescribed course.
This premature discontinuation not only leads to incomplete treatment but also gives surviving bacteria a chance to adapt and become resistant.
Also, a national survey by the Nigeria Centre for Disease Control (NCDC) also found that while healthcare workers have a moderate level of awareness about antimicrobial resistance, this knowledge does not always lead to appropriate prescribing practices.
According to the NCDC, even trained professionals can underestimate the importance of strictly following antibiotic guidelines.
For Hassan Muhammadu, a pharmacist based in Kano state, this is one of the most common issues he encounters in his daily practice.
“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.
He also highlighted the unregulated sale of antibiotics in informal markets across the country.
“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.
This trend is further exacerbated by the high cost of formal healthcare.
Mr Dapo Akin, a trader at Utako Market in the Federal Capital Territory, stated, “I just buy what the chemist recommends. Doctors are expensive, and I don’t have time for hospital queues”.
For some, peer advice outweighs medical expertise.
Ms Blessing Ojodomo, a university student, shared that her roommate advised her to take only three capsules because the full dose was “too strong”.
In response to the rising threat, government agencies are beginning to intervene.
For instance, Dr Jide Idris, Director-General of the NCDC, recently announced plans to introduce stricter regulations and improved monitoring of antibiotic sales.
“We are working on policies to ensure antibiotics are dispensed only with a valid prescription,” Idris noted.
He believes that these measures will help curb self-medication and promote adherence to prescribed treatments.
Beyond the immediate health dangers, antibiotic misuse also carries substantial economic costs.
Dr Abigail Banji, a health economist, explained that drug-resistant infections often require longer hospital stays and more expensive, second-line treatments.
“This not only strains individual finances but also burdens the national healthcare system,” Banji noted.
She cited a recent report by the Health Economics Research Unit at Obafemi Awolowo University, Ile-Ife, which warned that the cost of treating drug-resistant infections could rise sharply.
As a result, this could divert critical resources away from other essential healthcare services.
In the face of this growing crisis, some non-governmental organisations are taking grassroots action.
Public awareness campaigns are being carried out in markets and rural communities, aimed at educating people about antibiotic resistance and the importance of proper medication use.
Dr Chika Okeke, a public health advocate, stressed the value of communicating in local languages.
“If people don’t understand, they won’t change,” Okeke said.
Healthcare workers are also stepping up efforts within clinical settings.
Mrs Nkechi Uche, a nurse at Rhema Foundation Hospital Kwali said some facilities now ensure that patients receive proper counselling before being handed prescriptions.
“In my clinic, I don’t just hand out drugs, I explain why they must finish their medication,” Uche said.
Likewise, Dr Akujuobi Igwe, Laboratory and Research Director at Rotan Medical Diagnostics Ltd, urged both government and community leaders to support a nationwide public health campaign.
He emphasised that such a campaign should go beyond simply informing citizens to actively empowering them.
According to Igwe, a coordinated strategy combining stricter antibiotic regulations, public education, and grassroots engagement is vital to reversing current trends.
As Nigeria continues to confront the escalating challenge of antibiotic resistance, shifting public perception remains key.
For patients like Ugwu, the lesson has been learned the hard way.
“Now, I take all my medication, no matter how I feel,” she stated.
The pressing question remains: how many more Nigerians must face similar consequences before lasting change is achieved?
Health experts believe that with a concerted effort from government agencies, healthcare professionals, and community organisations, there is hope that this silent epidemic can ultimately be brought under control.
