COMPLIANCE WITH PROPHYLACTIC ANTIBIOTICS FOR OTITIS-MEDIA IN A NEW-YORK-CITY CLINIC

Although previous efficacy studies have reported high compliance rates among children treated by private physicians with prophylactic antibi otics for prevention of otitis media, compliance rates in a lower soci oeconomic, urban clinic population have not been well described. Eight y children who were placed on daily low dose antibiotics in the Pediat ric Otolaryngology Clinic at Bellevue Hospital were prospectively foll owed in order to estimate compliance in this population. Compliance wa s estimated by the parent's stated word alone. Of the 77 patients with records adequate for analysis, only 36 (46.8%) families claimed compl iance, 18 (23.4%) admitted non-compliance, and 23 (29.9%) did not reli ably return for follow-up clinic visits. Statistical analysis revealed that no single characteristic of the patient population or the treatm ent regimen strongly influenced compliance. The factors examined inclu ded: the child's age, sex, race and otologic diagnosis, the type of pr ophylaxis prescribed, the parent's ability to speak English, national origin, consistency of follow-up, and method of payment. Based on thes e results, less than half of the children attending an inner city clin ic complied with maintenance medication. The clinician should consider alternate treatment modalities, such as the insertion of middle ear v entilation tubes, if poor compliance with prolonged antibiotic treatme nt is suspected.