1.1 Introduction
Antibiotic resistance is defined as the ability of bacteria or other microorganisms to survive and multiply despite the presence of drugs designed to kill them or inhibit their growth (World Health Organization, 2020). This phenomenon is a growing global public health concern as it undermines the effectiveness of antibiotics, making infections harder to treat and increasing the risk of disease spread, severe illness, and mortality (Ventola, 2015). Antibiotic resistance emerges naturally through genetic changes in microorganisms; however, human factors such as over-prescription, misuse, and self-medication significantly accelerate its development and spread (Olayinka et al., 2019).
Urban communities, in particular, are increasingly vulnerable to the effects of antibiotic resistance due to high population density, frequent hospital visits, and easy access to antibiotics without proper medical guidance (Ayepola et al., 2021).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are significance of the study, scope of work, research hypothesis and questions, limitation of the study and definition of terms.
1.2 Background of Study
Historically, antibiotic resistance is closely tied to the discovery and widespread use of antibiotics in the 20th century. According to Ventola (2015), antibiotics were first introduced as revolutionary drugs capable of treating a wide range of bacterial infections, significantly reducing mortality and morbidity worldwide. However, even in the early years of antibiotic use, reports emerged indicating that bacteria were developing mechanisms to survive these drugs, signaling the beginning of antibiotic resistance as a public health concern (Murray et al., 2022). Olayinka et al. (2019) reported that urban communities, where pharmacies and drug vendors are abundant, have experienced higher rates of antibiotic misuse, which contributes to the accelerated development of resistant strains.
Researchers have asserted that urban healthcare facilities, including hospitals and clinics, play a central role in both treating infections and monitoring resistance trends, yet the lack of systematic surveillance has historically limited effective intervention (Ayepola et al., 2021). Over time, studies have affirmed that resistance patterns are not uniform and vary depending on the community, type of bacteria, and specific antibiotics used (Okeke et al., 2007).
In recent years, healthcare facilities like Fidson Healthcare Plc have increasingly become critical sites for understanding local resistance trends due to their large patient base and capacity to generate clinical data for research. Antibiotic resistance is increasingly recognized as a critical global health challenge, particularly in urban communities where population density and high healthcare demand accelerate the spread of resistant pathogens. According to Ventola (2015), the misuse and over-prescription of antibiotics are primary factors contributing to the rapid development of resistant bacterial strains. It is reported that in many urban areas of developing countries, including Nigeria, antibiotics are often accessed without proper medical prescriptions, which significantly elevates the risk of resistance (Olayinka et al., 2019).
Researchers have asserted that antibiotic resistance not only diminishes the effectiveness of common treatments but also results in longer hospital stays, higher medical costs, and increased mortality rates (Murray et al., 2022). Okeke et al. (2007) stated that poor public awareness and non-adherence to prescribed antibiotic regimens exacerbate the proliferation of resistant microorganisms. Furthermore, Ayepola et al. (2021) affirmed that healthcare facilities in urban centers serve as critical nodes for monitoring resistance trends, as they reflect both community and clinical antibiotic usage patterns (Ayepola et al., 2021).
It is contended that the lack of localized and up-to-date data on antibiotic resistance in urban healthcare settings limits the capacity of healthcare providers to make informed decisions regarding treatment protocols (World Health Organization, 2020). On the other hand, studies have reported that focused surveillance and research in specific healthcare facilities, such as Fidson Healthcare Plc, can provide valuable insights into local resistance patterns, ultimately guiding effective antibiotic stewardship and policy interventions (Ayepola et al., 2021). This study is set against the backdrop of rising antibiotic resistance in urban Nigerian communities and the pressing need for empirical research that examines resistance trends within healthcare facilities.
1.3 Statement of Problems
Investigation revealed that antibiotic resistance is emerging as one of the most pressing public health challenges in urban communities globally. The misuse and overuse of antibiotics in both clinical and non-clinical settings is a major factor driving this trend (Ventola, 2015). In many urban areas, including Nigeria, indiscriminate access to antibiotics without proper prescriptions is widespread, leading to the development of resistant bacterial strains that are harder to treat and manage (Olayinka et al., 2019).
Additionally, urban community settings often experience rapid population growth and high-density living conditions, which accelerate the transmission of resistant pathogens. These factors collectively create a cycle where antibiotic resistance continues to rise unchecked, posing serious health risks to the general population.
Furthermore, there is insufficient local data on the patterns and prevalence of antibiotic resistance in urban communities, particularly in healthcare facilities (Ayepola et al., 2021). It is also evident that healthcare practitioners face challenges in selecting appropriate antibiotics due to the absence of real-time resistance data, resulting in trial-and-error prescriptions that unintentionally promote resistance (Murray et al., 2022). It is against this backdrop that this study seeks to investigate the trends of antibiotic resistance in urban communities, using Fidson Healthcare Plc as a case study.
1.4 Aim and Objectives of Study
The aim of this study is to investigate the trends of antibiotic resistance in urban communities, using Fidson Healthcare Plc as a case study. In achieving this aim, the following specific objectives were laid out as follows:
- To evaluate the patterns of antibiotic use among patients in the urban community served by Fidson Healthcare Plc.
- To identify the most prevalent bacterial strains showing resistance in Fidson Healthcare Plc.
- To examine the factors contributing to antibiotic resistance in the study area.
- To assess the level of awareness and adherence to prescribed antibiotics among patients.
- To recommend strategies for effective antibiotic stewardship and resistance management.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What are the most prevalent bacterial strains showing resistance in Fidson Healthcare Plc?
- What are the common patterns of antibiotic use among patients in the urban community served by Fidson Healthcare Plc?
- What factors contribute to antibiotic resistance in the study area?
- What is the level of patient awareness and adherence to prescribed antibiotics?
- What strategies can be implemented to improve antibiotic stewardship and reduce resistance?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
- H01: There is no significant relationship between patient knowledge of antibiotics and adherence to prescribed antibiotic use.
- H02: There is a significant association between patterns of antibiotic use and the prevalence of antibiotic-resistant bacterial strains.
1.7 Significance of Study
It is believed that at the completion of the study, the research will improve patient awareness of proper antibiotic use and adherence. The research will also inform policymakers and regulatory bodies on strategies to reduce antibiotic misuse and enhance surveillance systems.
Furthermore, the study will assist healthcare professionals in selecting effective antibiotics and reducing trial-and-error prescriptions. In addition, the study will raise awareness of proper antibiotic use and encourage adherence to prescribed treatments.
Lastly, the research will contribute to the academic body of knowledge, providing a foundation for future studies on antibiotic resistance in Nigeria and similar urban settings.
1.8 Scope of Study
This study focuses on urban communities in Lagos State, Nigeria, with Fidson Healthcare Plc serving as the primary case study. The research is limited to evaluating the trends and patterns of antibiotic resistance among patients who access services at the healthcare facility. The study examines both bacterial isolates and patterns of antibiotic use, as well as factors influencing resistance in the community.
1.9 Limitations of the Study
During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
- Initial Cooperation Delay from Respondents: A particular limitation of this work came as a result of the respondent refusal to offer their cooperation at the initial time they were contacted. This contributed in making the success of this research study difficult.
1.10 Definition of Terms
Antibiotic Resistance:
Antibiotic resistance is the ability of microorganisms, especially bacteria, to survive and multiply despite exposure to drugs intended to inhibit or kill them (World Health Organization, 2020).
Antibiotic Stewardship:
According to Ventola (2015), antibiotic stewardship is a coordinated program that promotes the appropriate use of antibiotics to improve patient outcomes and reduce resistance.
Urban Community:
An urban community refers to a densely populated area with concentrated residential, commercial, and healthcare services, where the transmission of infectious diseases is more likely (Olayinka et al., 2019).
Bacterial Strains:
Bacterial strains are subtypes of bacteria classified based on genetic, phenotypic, or antibiotic susceptibility characteristics (Murray et al., 2022).
Fidson Healthcare Plc:
A private healthcare facility in Lagos State, Nigeria, providing a wide range of medical services including diagnostics, treatment, and prescription services for patients in urban communities.
…
