Poor compliance to antibiotics dispensed in a tertiary care hospital: a follow up study from Sri Lanka

Abstract

Introduction: Poor compliance with antibiotics is a well described phenomenon. This has contributed to the increased burden of antibiotic resistance in many countries. Objectives: This study was conducted to investigate patient compliance with antibiotic regimens in Sri Lanka. Methods: Patients who received antibiotics from one outlet of the outdoor pharmacy in Teaching Hospital, Karapitiya were enrolled into the study. An interviewer administered questionnaire was used to collect initial data. Three days after dispensing, follow up telephone calls were made to obtain information about adherence to dose and dose frequency. Results: Out of total 509 patients participated for the initial data collection, 318 (62.4%) responded to the telephone interview. Among the respondents, 169 (53.1%) were compliant with the antibiotic regimen. Of them 143 (45%) and 26 (8.1%) were fully compliant and marginally compliant with the antibiotic regimens respectively. The total number of patients who did not strictly adhere to the dose and frequency instruction were 28 (8.8%) and 171 (53.8%) respectively. Commonest reasons for noncompliance were forgetfulness, followed by intentionally withdrawal. Compliance was significantly associated with dosing frequency (X2=14.1; P=0.007) and indication for commencing antibiotics (X2=14.2; P=0.014). Postsurgical treatment and urinary tract infection had higher compliance than respiratory tract infections and skin infections. Conclusions: This study revealed alarmingly high rates of non-adherence to prescribed antibiotic regimens. This can contribute to emergence of resistance to commonly used antibiotics in Sri Lanka.

Keywords

• compliance
• antibiotics
• infection
• pneumonia
• resistance