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Compliance with antibiotic prophylaxis in children with sickle cell anemia: a prospective study

Enio Latini Bitarães1, Benigna Maria de Oliveira, Marcos Borato Viana

  • 1Fundação Mineira de Educação e Cultura - Faculdade de Ciências da Saúde (FUMEC-FCS), Belo Horizonte, MG, Brazil.

Jornal De Pediatria
|August 9, 2008
PubMed

Insights

Antibiotic prophylaxis compliance in children with sickle cell anemia was low, with medical records overestimating adherence. Multiple assessment methods are crucial for accurate measurement in pediatric sickle cell disease management.

Area of Science:

  • Pediatric Hematology
  • Infectious Disease Prevention
  • Pharmacology

Background:

  • Sickle cell anemia (SCA) necessitates antibiotic prophylaxis to prevent infections.
  • Accurate assessment of antibiotic compliance is vital for treatment efficacy in pediatric SCA.
  • Previous studies highlight challenges in measuring medication adherence in chronic pediatric conditions.

Purpose of the Study:

  • To prospectively evaluate compliance with antibiotic prophylaxis in children diagnosed with sickle cell anemia.
  • To compare different methods for assessing antibiotic adherence in this vulnerable pediatric population.
  • To identify factors influencing compliance rates in children with SCA.

Main Methods:

  • Prospective study involving 108 children (3 months to 4.5 years) with SCA over 15 months.
  • Compliance data collected via caregiver interviews, medical record review, and urine antibiotic assays.
  • Antibiotics provided free of charge to eliminate cost as a barrier.

Main Results:

  • Overall compliance rate was 67% when using a combined assessment approach.
  • Urine tests detected antibiotic presence in 56% of cases; 48% of caregivers reported full adherence.
  • Medical records showed a high (89%) recorded compliance, significantly overestimating actual adherence.
  • Low agreement was observed between different compliance assessment methods.

Conclusions:

  • Compliance with prophylactic antibiotics in pediatric sickle cell anemia is lower than often reported by medical records.
  • Assessing compliance requires a multi-method approach due to its complex nature.
  • A comprehensive educational program for healthcare professionals, families, and children is recommended to improve adherence.
Abstract

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