In a study of Israeli children with acute infections, adherence to oral antibiotic monotherapy was poor. Clinicians were unable to predict which patients would have better adherence. “These data are important when considering recommended treatment durations and developing interventional programs to increase adherence,” the investigators conclude.
The prospective, blinded, electronically monitored, observational study was conducted from Jan. 2018 to Oct. 2021. For patients aged 2 months to 5 years with an acute bacterial infection requiring short-term (5-10 days) oral antibiotic monotherapy, adherence was measured using an electronically monitored medication bottle. The primary outcomes were overall adherence (administration of >75% of doses relative to the number of doses prescribed) and timing adherence (administration of >75% of prescribed doses taken within ±20% of the prescribed interval).
“One hundred infants (49 boys, mean [range] age 1.87 years [0.2–5.1]) were included in the final analysis,” write the authors. “Only 11 participants received all the recommended doses. Overall adherence was 62%, whereas timing adherence was 21%. After applying a logistic regression model, the only factor significantly associated with nonadherence was being a single parent (odds ratio = 5.7; 95% confidence interval [1.07–30.3]). Prescribers overestimated adherence, defining 49 of 62 (77.7%) participants as likely adherent. Patients predicted to be adherent were not more likely to be adherent than those predicted to be nonadherent (31/47 actual adherence among those predicted to be adherent vs 6/16, P = .77).”