CARETAKER COMPLIANCE WITH DIFFERENT ANTIBIOTIC FORMULATIONS FOR TREATMENT OF CHILDHOOD PNEUMONIA

To determine the effect of antibiotic formulations on compliance, 400 children, aged 2 months to 5 years, with a presumptive diagnosis of pn eumonia, were randomly assigned to receive one of the following formul ations of cotrimoxazole:1. syrup accompanied by a 10-ml measuring cup; 2. syrup accompanied by a 5-ml measuring spoon; 3. tablets; 4. single -dose sachets of antibiotic powder. A research assistant visited the c hilds' home on the fourth day of therapy, asked the care-giver about c ompliance, and observed the care-giver prepare a dose of the medicatio n. The remaining amount of medicine was measured, and when possible (n = 151), a urine specimen was tested for the presence of sulphamethoxa zole. All of the care-givers reported giving at least one dose on the first day of therapy, By the fourth day, 82 per cent of those receivin g syrup were still taking their medication compared to 71 and 55 per c ent of those receiving sachets or tablets, respectively (P < 0.01), Of those who received syrup accompanied by a spoon, 38 per cent under-do sed the medicine by at least 30 per cent, Overall, compliance was high ly correlated with the care-giver's report of difficulty in administer ing the medication. Additional research is needed to understand the ob stacles encountered by care-givers in administering sachets and tablet s, Meanwhile, the use of antibiotic syrup, accompanied by an appropria tely sized measuring cup, appears to offer the greatest probability of medication compliance in the treatment of Egyptian children with pneu monia.