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Variation in acceptance of common oral antibiotic suspensions
R Dagan1, P Shvartzman, Z Liss
1Pediatric Infectious Diseases Unit, Soroka University Medical Center, Beer-Sheva, Israel.
Insights
Pediatric antibiotic suspension palatability significantly impacts treatment compliance. Cefaclor showed higher acceptance and compliance rates compared to amoxicillin, trimethoprim/sulfamethoxazole, and cefuroxime axetil in young children.
Area of Science:
- Pediatric Pharmacology
- Infectious Diseases
- Drug Compliance
Background:
- Palatability of oral antibiotic suspensions is a critical factor influencing treatment adherence in pediatric patients.
- Limited comparative data exists on the acceptance and compliance rates of commonly prescribed oral antibiotic suspensions.
- Variations in taste and formulation can significantly affect a child's willingness to take medication.
Purpose of the Study:
- To systematically assess and compare the acceptance and compliance of frequently used oral antibiotic suspensions in pediatric patients in Israel.
- To identify potential correlations between drug palatability and treatment adherence.
- To provide data to guide clinical decisions regarding antibiotic selection for young children.
Main Methods:
- A prospective study involving 546 pediatric patients receiving amoxicillin, cefaclor, cefuroxime axetil, or trimethoprim/sulfamethoxazole.
- Parents were contacted via telephone 10-14 days post-initiation of therapy to gather data on acceptance, side effects, and compliance.
- A standardized questionnaire with graded scores was used to quantify patient acceptance and parental satisfaction.
Main Results:
- Cefaclor demonstrated the highest acceptance rate (73%), with significantly lower rates for amoxicillin (60%), trimethoprim/sulfamethoxazole (55%), and cefuroxime axetil (20%) (P < 0.0001).
- Conversely, 'resentment' or 'refusal' was highest for cefuroxime axetil (56%) and lowest for cefaclor (11%).
- Mothers reported higher satisfaction with cefaclor (89%), and complete treatment courses were observed in 85% of children on cefaclor, compared to other antibiotics (P < 0.001).
Conclusions:
- Significant variations in palatability and compliance exist among commonly prescribed oral antibiotic suspensions for children.
- Cefaclor appears to be better accepted and adhered to by pediatric patients compared to amoxicillin, trimethoprim/sulfamethoxazole, and cefuroxime axetil.
- These findings underscore the importance of considering drug palatability in pediatric antibiotic prescribing to improve treatment outcomes.
Abstract:
Palatability of oral antibiotic suspensions is important and may be a substantial factor in determining compliance in young pediatric patients. Because no comparative systematic data are available, we undertook the present study to assess the acceptance of and compliance with oral antibiotic suspensions commonly used in Israel. During a 4-month period lists of children receiving oral antibiotic suspensions were obtained from 3 major pediatric clinics, and parents were contacted by telephone 10 to 14 days after initiation of therapy, at which time information on age, sex, main disease, prescribed drugs and duration of treatment was obtained. Information regarding acceptance, side effects and compliance was obtained from 11 questions with graded scores. In the study 546 children received one of the following drugs: amoxicillin (n = 222); cefaclor (n - 142); cefuroxime axetil (n = 107); trimethoprim/sulfamethoxazole (n = 75). No major differences in background data were noted; more than 50% of each group had acute otitis media. Seventy-three percent of the cefaclor group reported acceptance of the drug with "pleasure" or "without problems" vs. 60, 55 and 20% for amoxicillin, trimethoprim/sulfamethoxazole and cefuroxime axetil, respectively, whereas "resentment" or "refusal" was reported in 11, 16, 26 and 56%, respectively (P < 0.0001). Mothers reported to be generally "satisfied" or "extremely satisfied" with the drug in 89, 81, 74 and 67% with cefaclor, amoxicillin, trimethoprim/sulfamethoxazole and cefuroxime axetil, respectively, and 85, 77, 73 and 67% of the children, respectively, received the drug for the entire prescribed course (P < 0.001). Our data demonstrate that marked variations exist in acceptance and compliance of oral antibiotic suspensions with children.(ABSTRACT TRUNCATED AT 250 WORDS)