Poorly Regulated Antibiotic Use in Nigeria: A Critical Public Health Concern and Its Impact on Medical Practice.

Antibiotics have transformed the treatment of infectious diseases, but their widespread misuse has fueled an alarming rise in antimicrobial resistance (AMR), especially in low- and middle-income countries like Nigeria. Despite regulatory frameworks classifying antibiotics as prescription-only medicines, weak enforcement, self-medication, and informal drug sales have normalized inappropriate antibiotic use nationwide. A comprehensive narrative review was conducted, synthesizing evidence from peer-reviewed literature, surveillance reports from national and global health authorities, and policy documents. The review identifies key systemic, socioeconomic, and behavioral drivers of antibiotic misuse and their implications for clinical practice. Multiple factors, including weak pharmaceutical regulation, economic and geographic barriers to formal healthcare, public misconceptions, and poor pharmacovigilance, drive the misuse of antibiotics in Nigeria. These practices contribute to rising rates of multidrug-resistant infections, complicate routine procedures, increase treatment costs, and lead to diagnostic uncertainty. Clinicians face growing professional burnout due to repeated treatment failures and limited therapeutic options. The broader healthcare system is strained, and public trust in formal care is eroding. AMR in Nigeria is no longer a looming threat, it is a present crisis. Urgent, coordinated action is required to strengthen regulatory enforcement, improve healthcare access, implement antimicrobial stewardship, and invest in public health education. Without immediate intervention, Nigeria risks entering a post-antibiotic era where routine infections become life-threatening and modern medicine becomes increasingly ineffective.