Compliance issues related to the selection of antibiotic suspensions for children.
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.
Steele
R W
RW
Department of Pediatrics, LSU School of Medicine, New Orleans, LA, USA. RWSteele@aol.com
Thomas
M P
MP
Bégué
R E
RE
D000658:Amoxicillin / Q000008:administration & dosage / Q000191:economics; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000145:classification / Q000191:economics; D001291:Attitude of Health Personnel; D002675:Child, Preschool; D006801:Humans; D010033:Otitis Media / Q000188:drug therapy*; D010349:Patient Compliance; D017060:Patient Satisfaction; D010406:Penicillins / Q000008:administration & dosage / Q000191:economics; D010820:Physicians; D011306:Prescription Fees; D013535:Suspensions; D013649:Taste; D013997:Time Factors
D000900:Anti-Bacterial Agents; D010406:Penicillins; D013535:Suspensions; D000658:Amoxicillin