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Published on: April 18, 2019
Compliance issues related to the selection of antibiotic suspensions for children
R W Steele1, M P Thomas, R E Bégué
1Department of Pediatrics, LSU School of Medicine, New Orleans, LA, USA. RWSteele@aol.com
Insights
Choosing pediatric antibiotics involves more than just taste. Cost, therapy duration, and dosing intervals significantly impact compliance, influencing the final selection of effective antimicrobial treatments for children.
Area of Science:
- Pediatric Pharmacology
- Antimicrobial Stewardship
- Health Services Research
Background:
- Antibiotic suspensions are common in pediatric care.
- Selection often prioritizes palatability but overlooks compliance factors.
- Understanding compliance variables is crucial for effective treatment.
Purpose of the Study:
- To assess palatability, cost, and compliance issues in selecting pediatric antibiotic suspensions.
- To compare amoxicillin with 11 other commonly prescribed antibiotics.
- To determine the influence of various factors on antibiotic selection.
Main Methods:
- Eighty-six healthcare professionals evaluated 12 antibiotic suspensions.
- Evaluation criteria included appearance, smell, texture, taste, and aftertaste.
- Scoring was adjusted for cost, therapy duration (5 vs. 10 days), and dosing intervals.
Main Results:
- Palatability rankings varied, with loracarbef and cefdinir scoring highest.
- Overall antibiotic ratings were significantly influenced by cost, duration, and dosing.
- Final rankings, considering all variables, placed azithromycin and cefdinir highest.
Conclusions:
- Compliance factors are critical in selecting pediatric antimicrobial therapy.
- Cost is a consideration, particularly for higher-priced medications.
- Individualized assessment by healthcare providers is essential for optimal antibiotic selection.
Objective:
To evaluate the palatability, cost and other compliance issues as variables in the selection of antibiotic suspensions for children.
Methods:
Eighty-six physicians and health care personnel randomly sampled amoxicillin (used as a standard for comparison) and 11 other antibiotics, evaluating them in categories of appearance, smell, texture, taste and aftertaste. Overall scoring was then adjusted for cost, duration of therapy and dosing intervals.
Results:
Overall taste (palatability) ranking of antibiotics, highest to lowest, was as follows: loracarbef, cefdinir, cefixime, azithromycin, ciprofloxacin, trimethoprim-sulfamethoxazole, clarithromycin, trimethoprim, amoxicillin/clavulanate, cefpodoxime and cefuroxime. Overall rating of antibiotics was greatly influenced by other compliance variables, in order of their impact: cost; duration of therapy (5 vs. 10 days); and dosing intervals. Cost was not judged to be a major factor by most participants unless antibiotic expense was >$50.00 for treatment of otitis media in our hypothetical 2-year-old, 13-kg child. Taking all variables into consideration, final ranking from highest to lowest was azithromycin, cefdinir, loracarbef, cefixime, amoxicillin, trimethoprim-sulfamethoxazole, cefpodoxime, trimethoprim, clarithromycin, ciprofloxacin, cefuroxime and amoxicillin/clavulanate.
Conclusions:
Variables related to compliance for families filling antibiotic prescriptions and children taking these products are important in the selection of antimicrobial therapy. Because final assessment is likely to vary considerably among health care personnel, decisions must be made on an individual basis.
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