Background: Relationship between antibiotic use and emergence of resistance is complex; however, antibiotic misuse in clinical practices alone cannot explain the high frequency of antibiotic resistant bacteria in developing countries.
Methods: Comparative bacteriostatic potentials of oral paediatric anti- biotics sold in Nigeria and Dubai were determined on 83 diarrhoea- genic bacterial strains, using modified agar well-diffusion method.
Findings: Highest overall in vitro percentage resistance were 60.0- 91.7% against Safetum [cefpodoxime proxetil 240 mg N11], sold in Nigeria, while Septrin 240 mg [sulfamethoxazole + trimethoprim 240 mg D1] (33.3-71.4%) and Cefodox [cefpodoxime proxetil 100 mg D3] (54.5-75.0%) sold in Dubai were the most-resisted. Lowest overall resistance were displayed against Augmentin [amoxicillin + clavulanate potassium 228 mg N14] (0.0-10.0%) sold in Nigeria but Megamox [amoxicillin + clavulanic acid 228 mg D4 and 156 mg D6] (0.0-8.3% and 0.0-17.1%) sold in Dubai, were the least-resisted. Relatively wid- er zones of inhibition were recorded for paediatric antibiotics sold in Dubai. Nigerian-sold Tambac 50 mg [N4] and Safetum 240 mg [N11], manufactured in India and of the same active ingredients (cef- podoxime proxetil) exhibited significantly different resistance profiles of 9.1-41.7% and 60.0-91.7% respectively. Two amoxicillin derivatives sold in Nigeria, Amoxigram (amoxicillin) 250 mg [N12], manufactured in Malaysia and Augmentin (amoxicillin + clavulanate) 228 mg [N14]. manufactured in UK exhibited different resistance profiles of 13.3- 33.3% and 0.0-10.0% respectively. Sold in Dubai amoxicillin derivative antibiotics- Megamox 228 mg [D4] and 156 mg [D6], manufactured in Saudi Arabia exhibited 0.0-8.3% and 0.0-17.1% respectively, while Neomox 250 mg [D5] and 125 mg [D7], manufactured in United Arab Emirates exhibited 9.1-28.6% and 9.1-50.0% resistance respectively.
Conclusion: Place of manufacture and place of purchase of antibiotics can contribute to the globally reported high prevalence of antibiotic resistance.