Change From Twice Daily To Once Daily Dose Significant

Comparison of patient compliance with once-daily and twice-daily antibiotic regimens in respiratory tract infections: results of a randomized trial [Abstract]

Kardas P.J Antimicrob Chemother. 2007 Feb 8; [Epub ahead of print]

Abstract

Background Patient compliance seems to be highly dependent on the number of daily doses. However, it is unclear whether this effect is still present in the case of infrequent regimens during short-term antibiotic treatment. The aim of this study was to find out whether a once-daily antibiotic regimen provides better patient compliance in the case of common respiratory tract infections than a twice-daily regimen. Methods Outpatients with acute bacterial exacerbation of chronic bronchitis were treated with clarithromycin 250 mg twice daily or clarithromycin in modified release formulation 500 mg once daily, for 7 days in a prospective, randomized, single-centre study. Patient compliance was assessed with electronic monitoring. Results Of 122 patients randomized, 119 were evaluable (58 in the once-daily group and 61 in the twice-daily group). All the studied parameters indicated significantly better compliance with the once-daily versus twice-daily antibiotic formulation: overall compliance (93.7% versus 81.3%, P < 0.0001), days with correct number of doses taken (80.3% versus 68.6%, P < 0.0001), correct interdose intervals (74.4% versus 56.4%, P < 0.001), and the mean interdose intervals (95.6% versus 106.3% of the expected values, P < 0.001). Conclusions The study has proved much better patient compliance with a once-daily versus a twice-daily antibiotic regimen. This effect has been marked in both dosing and timing compliance. These findings indicate the clinical usefulness of a once-daily antibiotic regimen in assuring patient compliance during the treatment of respiratory tract infections.

Commentary

This study is further evidence supporting the notion that reducing frequency of dosages enhances medication compliance. The parameters of the project are especially useful, demonstrating a significant improvement for a seven day course of treatment (such studies have tended to focus on chronic use of a medication) and for a shift from twice a day to once a day dosing (earlier studies have focused on the differences between once or twice daily dosing and three times a day and higher dosing).

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