'Cut medicine for me': addressing suboptimal dosing of antimicrobials as a critical issue to combat AMR in Nigeria

Abstract

Antimicrobial resistance (AMR) is a critical health challenge in Nigeria as in many other countries in the sub-Saharan region of Africa. Our article describes how the challenges in the regulation and operations of Patent and Proprietary Medicine Vendors (PPMVs) in Nigeria provide a blind spot for the underuse of antimicrobials. This article also sheds light on how patients' antibiotic use and seeking behaviour facilitate this unwholesome practice. In addition, our article looks at the social determinants of this practice, such as poverty and poor education, and proffers solutions towards solving it. While previous research has investigated the knowledge, perceptions and attitudes of PPMVs towards antimicrobial use and AMR, our article is the first to critically raise concerns about the common practice of antimicrobial underdosing in Nigeria.