Cals Jochen W L, Hopstaken Rogier M, Le Doux Philippe H A, Driessen Ger A, Nelemans Patricia J, Dinant Geert-Jan
Department of General Practice, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Int J Antimicrob Agents. 2008 Jun;31(6):531-6. doi: 10.1016/j.ijantimicag.2008.01.029. Epub 2008 May 5.
The objective of this study was to assess compliance with a 10-day treatment of antibiotics or placebo once-daily (OD) and three-times-daily (TD) for lower respiratory tract infections (LRTIs) using electronic monitoring, and to evaluate whether compliance depends on time since the start of treatment and weekday. Taking compliance, timing compliance, correct dosing compliance and mean interdose intervals were assessed using data from 155 LRTI patients who received either a 10-day treatment of amoxicillin TD and placebo OD or roxithromycin OD and placebo TD using a double-dummy technique. Compliance was assessed by electronic monitoring. Taking compliance was 98.0% for the OD regimen and 91.0% for the TD regimen. Correct dosing was 98.1% for the OD regimen and 91.1% for the TD regimen and timing compliance was 48.2% and 10.9%, respectively. The mean interdose interval before the first daily dose for the TD group was particularly prolonged to >13h. Correct dosing over time showed fewer patients with correct dosing compliance, reaching a low of 79% for the TD group towards the end of the 10-day treatment. Compliance was not influenced by weekday. This study adds important information to the limited evidence on compliance with antibiotics for LRTI, one of the most common reasons for consultation in primary care. Taking compliance was high for both regimens, yet timing compliance was poor. The prolonged mean interdose intervals provide striking new insights into understanding non-compliance with more-than-once-daily regimens. These findings require consideration when exploring ways to improve future compliance in short-term antibiotic treatment for respiratory tract infections.
本研究的目的是通过电子监测评估针对下呼吸道感染（LRTIs）进行为期10天的每日一次（OD）和每日三次（TD）抗生素或安慰剂治疗的依从性，并评估依从性是否取决于治疗开始后的时间和工作日。使用双盲法技术，对155例接受为期10天阿莫西林TD和安慰剂OD治疗或罗红霉素OD和安慰剂TD治疗的LRTI患者的数据进行分析，评估服药依从性、定时依从性、正确剂量依从性和平均给药间隔时间。通过电子监测评估依从性。OD治疗方案的服药依从性为98.0%，TD治疗方案为91.0%。OD治疗方案的正确剂量为98.1%，TD治疗方案为91.1%，定时依从性分别为48.2%和10.9%。TD组首次每日剂量前的平均给药间隔时间特别延长至>13小时。随着时间的推移，正确剂量显示正确剂量依从性的患者减少，TD组在10天治疗结束时降至79%的低点。依从性不受工作日的影响。本研究为基层医疗中最常见的就诊原因之一——LRTI抗生素治疗依从性的有限证据增添了重要信息。两种治疗方案的服药依从性都很高，但定时依从性较差。延长的平均给药间隔时间为理解每日多次给药方案的不依从性提供了惊人的新见解。在探索改善未来呼吸道感染短期抗生素治疗依从性的方法时，需要考虑这些发现。
