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The problem of bacterial resistance to antibiotics among strains isolated from hospital patients in Lagos and Ibadan, Nigeria.

Bacterial infections are still an important cause of illness and death in developing countries, where the widespread and indiscriminate use of antibiotics has led to serious problems of resistance to the older, less expensive agents. The results of routine sensitivity testing of clinical isolates from patients in Lagos and Ibadan, Nigeria show a high prevalence of strains resistant to penicillin, tetracycline, ampicillin, co-trimoxazole and chloramphenicol, with between 70% and 90% of strains of Enterobacteriaceae, including Escherichia coli and Klebsiella and Proteus species being resistant to many of the commonly available antibiotics. These resistance rates are generally higher than those found in Europe, although in some countries in southern Europe rates are not dissimilar to those found in Nigeria. Control of antibiotic use in developing countries is probably impossible at the present time, as in many cases antibiotics are used for self-treatment without prescription. For hospital patients, the use of the older and cheaper anti-bacterial agents is unlikely to be either medically or cost effective without adequate laboratory diagnostic facilities to provide guidance on possible therapy within the financial resources of the patients.