Rev Esp Quimioter 2009;22(1):20-24

Compliance rate of antibiotic therapy in patients with acute pharyngitis is very low, mainly when thrice-daily antibiotics are given

C. Llor ,  N. Sierra ,  S. Hernández ,  C. Bayona ,  M. Hernández ,  A. Moragas y O. Calviño 


Objective. To assess drug-compliance observed among patients with suspected streptococcal pharyngitis treated with twice-daily antibiotic regimens (b.i.d.) and others with thrice-daily regimens (t.i.d.).

Methods. A prospective study in the primary care setting was designed in which patients with pharyngitis and three or more Centor criteria, non-allergic to beta-lactam agents, treated with several b.i.d and t.i.d antibiotic regimens based on doctor’s choice, were recruited. Patient compliance was assessed with electronic monitoring.

Results. A total of 113 patients were enrolled (64 in the t.i.d. group and 49 in the b.i.d. group). Mean openings ranged from 70.3 to 83.3% of the total amount of pills. All the parameters analysed indicated significantly worse compliance with the t.i.d. regimens. Eleven patients allocated to the t.i.d. group took at least 80 % of the pills (17.2 %), this being significantly lower than those who received b.i.d. antibiotics (59.2%; p<0.001). The percentage of patients who opened the Medication Event Monitoring System (MEMS) container the satisfactory number of times a day was systematically lower among t.i.d. regimens, this being statistically significant from day three (p<0.05). Patients assigned to t.i.d. regimens more frequently forgot the afternoon dose.

Conclusion. Compliance rate was very low, mainly when patients are given t.i.d antibiotic regimens. This may lead to storage of antibiotics and subsequent selfmedication. New strategies addressed to improve drugcompliance with antibiotics among outpatients are therefore necessary.


Key words: Compliance. Pharyngitis. Streptococcal infection. Amoxicillin. Penicillin. Antibiotic.

Rev Esp Quimioter 2009;22(1):20-24  [pdf]