title: [Acceptability, compliance and schedule of administration of oral antibiotics in outpatient children].
abstract: BACKGROUND
  Compliance with antibiotics is essential to ensure treatment efficacy and to prevent the emergence of bacterial resistant stains. In children who take oral form, the palatability and the frequency of administration seem to be factors important to good compliance.
  
  
  METHODS
  This observational study was designed to assess the acceptability of oral antibiotics (including generics) commonly prescribed to children by primary care physicians in France. It was given to 50 pediatricians and 50 GPs in private practice. For each patient, the physician and parents completed a questionnaire, and parents filled out a log for each drug intake.
  
  
  RESULTS
  Between September 2006 and September 2007, 91 physicians enrolled 2400 children and 1482 patient records are fully assessable. The two factors that improve significantly compliance are administration in two doses by day (OR 2.2 [95% CI 1 6-3]) and acceptability ≥80% (OR 2.6, [95% CI 1.9-3.7]). The acceptability was better for amoxicillin-clavulanic acid 65.4% (95% CI [57.6 to 72.4]) than for cefpodoxime 47.1% (95% CI [43.8-50.4]) or cefuroxime axetil 26% (95% [CI 15.9-39.6]). Conversely, cefpodoxime proxetil obtained a better score for compliance 91.8% (95% CI [89.8 to 93.4) as amoxicillin-clavulanic acid 84.6% (95%CI 80.8 to 87.8) because of its mode of administration in two doses per day. There is no difference between the amoxicillin clavulanic acid reference product and its generics as a whole, however a large variability exists between generics. If, for antibiotics prescribed in two doses per day, the two administrations by day are roughly equidistant, it is not the same for those prescribed three times a day: indeed, while the doses taken are identical, only four hours separate the first intake of the morning from the second intake in mid-day and more than 12 hours between the evening dose from the next morning intake.
  
  
  CONCLUSIONS
  This study confirms the disparity in terms of acceptability among the different antibiotics prescribed for children even for the same drug, warranting evaluation for marketing of future generic drugs pediatric oral suspension. The disparity ranges for drugs three times daily asking consequences pharmacokinetics and dosage adjustment for a transition to two doses per day.
authors.affiliation: 20-22, boulevard Galliéni, 94130 Nogent-sur-marne, France; Activ, 27, rue d'Inkermann, 94100 Saint-Maur-Des-Fosses, France.
authors.forename: A
authors.initials: A
authors.lastname: Wollner
authors.affiliation: Activ, 27, rue d'Inkermann, 94100 Saint-Maur-Des-Fosses, France.
authors.forename: A
authors.initials: A
authors.lastname: Lécuyer
authors.affiliation: Activ, 27, rue d'Inkermann, 94100 Saint-Maur-Des-Fosses, France.
authors.forename: F
authors.initials: F
authors.lastname: De La Rocque
authors.affiliation: 87, boulevard de Port-Royal, 75013 Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Sedletzki
authors.affiliation: Activ, 27, rue d'Inkermann, 94100 Saint-Maur-Des-Fosses, France; 154, avenue du Général-de-Gaulle, 94500 Champigny-sur-marne, France.
authors.forename: V
authors.initials: V
authors.lastname: Derkx
authors.affiliation: Activ, 27, rue d'Inkermann, 94100 Saint-Maur-Des-Fosses, France; 7, avenue des Arts, 94100 Saint-Maur-Des-Fosses, France.
authors.forename: M
authors.initials: M
authors.lastname: Boucherat
authors.affiliation: Activ, 27, rue d'Inkermann, 94100 Saint-Maur-Des-Fosses, France; 157, avenue du Général-Leclerc, 94700 Maisons-Alfort, France.
authors.forename: A
authors.initials: A
authors.lastname: Elbez
authors.affiliation: AFPA.
authors.forename: N
authors.initials: N
authors.lastname: Gelbert-Baudino
authors.affiliation: Activ, 27, rue d'Inkermann, 94100 Saint-Maur-Des-Fosses, France.
authors.forename: C
authors.initials: C
authors.lastname: Levy
authors.affiliation: Activ, 27, rue d'Inkermann, 94100 Saint-Maur-Des-Fosses, France; 14, avenue de Quincy, Combs-la-ville, France.
authors.forename: F
authors.initials: F
authors.lastname: Corrard
authors.affiliation: Activ, 27, rue d'Inkermann, 94100 Saint-Maur-Des-Fosses, France; Centre hospitalier intercommunal de Créteil, 40, avenue de Verdun, 94000 Créteil, France.
authors.forename: R
authors.initials: R
authors.lastname: Cohen
mesh_terms: D000284:Administration, Oral; D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016903:Drug Monitoring
chemical_list: D000900:Anti-Bacterial Agents