Electronically Monitored Adherence to Short-Term Antibiotic Therapy in Children

Area of Science:

• Pediatric infectious diseases
• Pharmacology and therapeutics
• Public health

Background:

• Nonadherence to short-term antibiotic regimens in children can lead to treatment failure.
• This can also contribute to the development of antimicrobial resistance.
• Reliable adherence estimates are crucial for effective pediatric treatment strategies.

Purpose of the Study:

• To determine adherence rates to short-term antibiotic treatment in young children.
• To identify factors associated with nonadherence in this population.
• To assess the accuracy of healthcare providers' predictions of patient adherence.

Main Methods:

• A prospective, blinded, observational study utilizing electronic monitoring of medication bottles.
• Included 100 children aged 2 months to 5 years with acute bacterial infections.
• Defined overall adherence as >75% of prescribed doses and timing adherence as >75% of doses within ±20% of the prescribed interval.

Main Results:

• Overall adherence was 62%, with timing adherence at 21%.
• Only 11% of participants received all prescribed doses.
• Being a single parent was the only factor significantly associated with nonadherence (OR = 5.7).
• Healthcare providers significantly overestimated adherence, with no correlation between predicted and actual adherence.

Conclusions:

• Pediatric adherence to short-term antimicrobial treatment for acute infections is suboptimal.
• Healthcare providers are unable to accurately predict patient adherence.
• Findings highlight the need for interventions to improve adherence and inform treatment duration recommendations.