Compliance with antibiotic therapy: a comparison of deuterium oxide tracer, urine bioassay, bottle weights, and parental reports.
Compliance with antibiotic therapy: a comparison of deuterium oxide tracer, urine bioassay, bottle weights, and parental reports.
复制标题
抗生素治疗的依从性：氧化氘示踪剂、尿液生物测定、瓶子重量和家长报告的比较。
DOI：
10.1016/s0022-3476(05)81560-4
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发表时间：
1993
期刊：
影响因子：
--
通讯作者：
Pichichero,ME
中科院分区：
文献类型：
--
作者：
Rodewald,LE;Pichichero,ME
目的：比较3种传统的抗菌药物治疗依从性指标(父母报告日记、服药前和服药后的瓶重差值、抗生素活性的尿液生物测定)与氧化氢示踪法的依从性。方法：对参与阿奇霉素和青霉素治疗A组β溶血性链球菌感染的受试者进行临床试验。研究对象为41名儿童，年龄3~15岁(平均7.9岁)，来自郊区的一家儿科私人诊所，快速链球菌抗原检测结果为阳性。从所有四项指标来看，合规性都很高。家长日记显示，所有剂量都被注射了。对40名受试者进行了尿液生物检测，均显示出抗菌活性。获得了27名受试者瓶子重量的差异，结果显示，在方案结束时，142%的处方药物从瓶子中丢失。对40名受试者进行了氧化氢测量，结果显示处方阿奇霉素的107%和处方青霉素的92%被摄取。测量结果与预期的相关系数为0.89。结论：瓶重测量高估了患者的依从性，在办公室环境中使用氧化氢示踪剂是可行的，并在预期尿液浓缩与实际浓缩之间产生高度的相关性。更多地使用这种定量和直接的测量方法将提高儿科液体药物试验中依从性测量的准确性。
Objective: To compare three traditional measures of compliance with antiblotic therapy (parent report diary, preregimen and postregimen bottle-weight difference, and urine biosssay for antibiotic activity) with a deuterium oxide tracer measure of compliance.Methods: Clinical trial in which all four compliance measures were used for subjects participating in a comparison of the efficacy of azithromycin and penicillin in treating group A β-hemolytic streptococcal infection. Subjects were 41 children, aged 3 to 15 years (average age, 7.9 years), in a suburban pediatric private practice, who had positive rapid streptoccccal antigen test results.Results: Of the 41 subjects, 20 children were randomly assigned to receive azithromycin and 21 to receive penicillin. Compliance was uniformly high by all four measures. Parent diaries indicated that all doses were administered. Urine bioassays were obtained for 40 subjects, and all showed antibiotic activity. Differences in bottle weights were obtained for 27 subjects and showed that 142% of the prescribed medication was missing from the bottles at the end of the regimen. The deuterium oxide measure was obtained for 40 subjects and showed that 107% of the prescribed azithromycin and 92% of the prescribed penicillin were ingested. The correlation coefficient between measured and expected deuterium enrichment was 0.89. There was no significant correlation between the bottle-weight measure and the deuterium oxide tracer.Conclusions: The bottle-weight measure overestimates compliance; the deuterium oxide tracer is feasible for use in an office setting and produces a high correlation between the expected urinary enrichment and the measured enrichment. Increased use of this quantitative and direct measure would improve the accuracy of compliance measurement in trials of pediatric liquid medications.