Compliance to antibiotic therapy at paediatric out-patient clinic

Abstract

Background: Poor compliance to antibiotic therapy leads to ineffective treatment. Objective: The objective of this study is to assess compliance to oral antibiotic therapy in paediatric patients and factors affecting it. Methods: Patients aged less than 18 years, coming to outpatient department, who were prescribed oral antibiotics in last 1 week, were eligible for participation in the study. Compliance to oral antibiotic therapy and factors affecting it were evaluated through verbal interview of their caretakers. Results: Out of total of 815 participants in the study, 241 (29.6%) were non-compliant either due to not completing the course [142 (17.4%)] or due to not complying with the frequency [99 (12.2%)]. Causes of incomplete course were adverse effects [28 (19.7%)], poor palatability [30 (21.1%)] and no improvement [84 (59.2%)]. Gender, religion, age, development of child and education or occupational status of caregiver did not affect the compliance. Multivariable logistic regression showed two or more drugs in addition to antibiotic therapy (odds ratio [OR] 1.73; 95% confidence interval [CI] 1.03–2.92); more frequency intake of antibiotic in a day, that is, either twice a day (OR 2.13; 95% CI 1.24–3.66) or thrice a day (OR 3.7; 95% CI 2.18–6.48), was significantly associated with non-compliance. Though syrup formulation and low cost of prescription were associated with better compliance on univariate analysis, they did not have any impact in multivariable logistic regression. Conclusions: Restricting use of unnecessary drugs with antibiotic therapy, preferring once-a-day frequency and carefully selecting antibiotic with minimal adverse effects and better palatability improve the compliance to oral antibiotic therapy in paediatric patients.

Keywords

• adherence
• caregiver
• children
• medication