Conflict of interest statement: The MEMS containers were provided through a grant from GlaxoSmithKline. The authors declare that they did not receive any direct economical support for undertaking this study.
Comparison of adherence between twice- and thrice-daily regimens of oral amoxicillin/clavulanic acid
Article first published online: 19 APR 2012
© 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology
Volume 17, Issue 4, pages 687–692, May 2012
How to Cite
LLOR, C., BAYONA, C., HERNÁNDEZ, S., MORAGAS, A. and MIRAVITLLES, M. (2012), Comparison of adherence between twice- and thrice-daily regimens of oral amoxicillin/clavulanic acid. Respirology, 17: 687–692. doi: 10.1111/j.1440-1843.2012.02159.x
- Issue published online: 19 APR 2012
- Article first published online: 19 APR 2012
- Accepted manuscript online: 5 MAR 2012 04:26PM EST
- Received 13 October 2011; invited to revise 17 November 2011; revised 30 November 2011; accepted 15 December 2011 (Associate Editor: Marcos Restrepo).
- amoxicillin-potassium clavulanate combination;
- drug administration schedule;
- micro-electrical-mechanical system;
- patient compliance;
- respiratory tract infection
Background and objective: Few studies have analysed adherence with antibiotic treatment in patients with respiratory tract infections. The aim of this study was to compare the compliance of patients taking a pharmacokinetically enhanced formulation of amoxicillin/clavulanic acid twice daily with that of patients taking the standard formulation thrice daily.
Methods: Patients with suspected bacterial lower respiratory tract infections, pharyngitis and dental infections were included. Adherence was assessed by electronic monitoring, which recorded every opening of the patient's bottle of pills. The outcome variables were compliance with taking the medication, taking the correct dose and with timing of the dose.
Results: A total of 240 patients were enrolled (167 in the thrice-daily group and 73 in the twice-daily group). The percentage of doses taken was greater with the twice-daily regimen (84.5 ± 22.8%) than with the thrice-daily regimen (72.7 ± 20.1%; P < 0.001). Forty patients in the twice-daily group opened the container every 12 ± 6 h during at least 80% of the course (54.8%), while only 19.6% of the patients assigned to the thrice-daily formulation did so every 8 ± 4 h (P < 0.001). The percentage of patients who opened the container a satisfactory number of times per day was significantly higher among those taking the twice-daily regimen on days three, four, five, six and seven. Moreover, the thrice-daily group more frequently forgot to take the afternoon dose.
Conclusions: The rate of compliance with amoxicillin/clavulanic acid therapy was very low. However, compliance with the new formulation that is taken twice-daily was significantly better.