Treatment patterns in pediatric antibiotic formulations: An analysis of the ramq database


      In clinical practice, the taste of liquid pediatric antibiotics may contribute to treatment acceptance and compliance. The purpose of this study was to analyze treatment patterns and persistence with liquid pediatric antibiotics, in a real life setting, using the RAMQ database.


      Selected patients were < than 20 years old and were covered by the Quebec provincial drug reimbursement program (RAMQ). They were prescribed a liquid pediatric antibiotic (branded or generic formulation) during the period from July 2008 to April 2011 at least once. The analyses evaluated patients and treatment characteristics and patterns in terms of short-term (30 days or less) and long-term (> than 30 days) repeated use.


      Data were available for a sample of 67,727 patients who used an antibiotic of interest. The average age of the study population was 4.7 years (SD=3.5) and 89.9% were < than 10 years old. The proportion of boys versus girls was similar (51.2% versus 48.8%, respectively). Amoxicillin trihydrate and macrolides, clarithromycin and azithromycin were most often used (49.3% and 33.0%, respectively). About 55.4% of children received more than one antibiotic during the study period. Among children who received a second antibiotic, about 22.5% required it within 30 days following treatment initiation. In the short-term, the need for a second antibiotic was more frequent when cephalosporin was the initial treatment. In the long-term, when the initial treatment was amoxicillin or a macrolide, subsequent antibiotics were more likely to be the same as the first antibiotic.


      Many children will require more than one antibiotic treatment during their childhood. Several factors may contribute to short-term acceptance and compliance of the initial antibiotic, one of which may be taste. The better the acceptance and compliance to the initial antibiotic, the more likely the same antibiotic will be used for subsequent treatments.