A new study reveals that patient behavior – particularly the failure to complete full courses of medication – is reducing the effectiveness of antibiotic treatment of infections.
Behaviors identified in the study include a tendency to stop taking medication once symptoms were relieved and a trend for patients who were prescribed multiple doses of a specific medication in a single day to “skip” doses throughout their course of treatment.
The global survey, commissioned by Pfizer and conducted among 4,500 people in 11 countries, revealed that only six in ten people understood that taking an antibiotic improperly may reduce its effectiveness.
The COMPLY study (COmpliance, Modalities by Population, Lifestyle and Geography) discovered almost a quarter (22 percent) of those questioned admitted being noncompliant with their last antibiotic treatment.
Younger people were the most likely to not complete their full course of medication.
“What is extremely important in the Middle East and beyond is for people to understand the importance of completing their full course of medical treatment using antibiotics,” said Dr. Muaaz Tarabichi, Head of ENT department, American Hospital –Dubai. “Although people may feel better once their symptoms are relieved, the reality is that the underlying infections may not be completely countered unless the full course is taken as instructed by the physician.”
COMPLY found noncompliance rates were greater than 30 percent in some countries, with age a major factor, as younger patients tended to be more likely to skip doses or prematurely end treatment.
Experts agree that the age factor is particularly relevant within the Middle East where younger populations are prevalent. Noncompliance among those aged between 18 and 29 was twice as high (30 percent) compared to those aged 60 and older (14 percent).
The dosage of antibiotics was also a significant predictor of compliance. For example, people were more likely to be noncompliant when taking more doses per day, with 15 percent noncompliance among patients taking one dose per day compared to 27 percent among those taking three or more doses per day.
To counter this problem, the new generation of antibiotics is being designed to help increase levels of patient compliance. Treatments like Zithromax SD deliver a complete course of therapy in a single two-gram dose.
In the first 24 hours after a dose of the treatment, the amount of drug that gets into the tissue is three times higher than a standard dose of alternative antibiotic treatments. This “front loading” provides high drug levels earlier in the course of infection when the bacterial burden is likely to be highest.
The COMPLY research was led by an international steering committee composed of world-class experts including Jean-Claude Pechère, steering committee chair, Department of Genetics and Microbiology, University of Geneva, Switzerland and Giuseppe Cornaglia, president-elect ESCMID, Department of Pathology, University of Verona, Italy.
“COMPLY provides insight into patient behaviors and attitudes that impact compliance,” said steering committee member Giuseppe Cornaglia. “Many patients forget to take medication or interrupt their treatment when they begin to feel better, creating an ideal envi¬ronment for bacteria to adapt rather than be killed.”
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