Soares Neelkamal, Mitchell Rachel, McGoff Theresa, Bailey Teresa, Wellman Gregory S
Department of Pediatric and Adolescent Medicine (NS), Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI.
Ferris State University College of Pharmacy (RM, TB, GSW), Big Rapids, MI.
J Pediatr Pharmacol Ther. 2022;27(4):316-323. doi: 10.5863/1551-6776-27.4.316. Epub 2022 May 9.
Palatability of medication is an important factor for adherence, especially in pediatric populations that tend to use oral suspensions for antibiotic therapy. Our study is the first to evaluate the impact of taste on prescribing patterns of antibiotic suspensions. The objective was to determine if taste testing common antibiotic suspensions altered prescribing patterns of medical residents, through data extracted from the electronic health record.
After assessing 5 "primer" tastes (sweet, salty, bitter, sour, umami [savory]), residents were randomized to sample 6 antibiotic suspensions to rate their taste perception. A 12-month retrospective and prospective analysis of outpatient prescribing practices of the residents followed, and the results were compared to the resident cohort randomized to no taste test.
The 43 residents prescribed 207 liquid antibiotic prescriptions for 176 patients, with no difference in patient characteristics between residents in the taste test versus non-taste test group. Although amoxicillin was most preferable and amoxicillin-clavulanate least, the only significant finding was a greater prescribing rate of cefdinir among those who had tasted it and an inverse relationship between cephalexin taste preference and percentage prescribing amoxicillin in the taste group. Residents who tasted were poor in identifying primer tastes, but this did not impact prescribing patterns.
Among 6 commonly prescribed antibiotic suspensions, amoxicillin remains a highly preferred taste among prescribers. Interestingly, after the taste test there was a significantly greater prescribing rate of cefdinir among those who had tasted it and somewhat lower prescribing rate for amoxicillin-clavulanate.
药物的适口性是影响依从性的一个重要因素,对于倾向于使用口服混悬液进行抗生素治疗的儿科人群而言尤其如此。我们的研究首次评估了口味对抗生素混悬液处方模式的影响。目的是通过从电子健康记录中提取的数据,确定对常见抗生素混悬液进行口味测试是否会改变住院医师的处方模式。
在评估了5种“基本”口味(甜、咸、苦、酸、鲜味[美味])后,住院医师被随机抽取6种抗生素混悬液样本,对其口味感知进行评分。随后对住院医师门诊处方实践进行了为期12个月的回顾性和前瞻性分析,并将结果与随机分配到未进行口味测试组的住院医师队列进行比较。
43名住院医师为176名患者开具了207份液体抗生素处方,口味测试组与非口味测试组住院医师的患者特征无差异。虽然阿莫西林最受欢迎,阿莫西林-克拉维酸最不受欢迎,但唯一显著的发现是,品尝过头孢地尼的人开具该药的比例更高,且在口味测试组中,头孢氨苄口味偏好与阿莫西林处方百分比之间呈负相关。品尝过的住院医师在识别基本口味方面表现较差,但这并未影响处方模式。
在6种常用的抗生素混悬液中,阿莫西林在开处方者中仍是最受欢迎的口味。有趣的是,口味测试后,品尝过头孢地尼的人开具该药的比例显著更高,而阿莫西林-克拉维酸的处方比例则略低。