Assessment of the palatability of beta-lactamase-resistant antibiotics in children
D. Matsui, R. Lim, T. Tschen and M. J. Rieder
Department of Paediatrics, University of Western Ontario, Children's Hospital of Western Ontario, London.
OBJECTIVES: To evaluate the palatability of antibiotics effective against
beta-lactamase-producing bacteria in children and to compare the results
obtained with those obtained in adults. DESIGN: A taste test of 4
antibiotic suspensions: a combination of amoxicillin and clavulanic acid
(banana), azithromycin (cherry), clarithromycin (wild fruit), and a
combination of erythromycin and sulfisoxazole (strawberry-banana). SETTING:
Outpatient setting. SUBJECTS: A volunteer sample of 50 healthy children
(mean +/- SD age, 6.3 +/- 1.3 years) and 20 adults. MAIN OUTCOME MEASURES:
After each antibiotic test dose, subjects rated its taste on a 10-cm visual
analog scale incorporating a facial hedonic scale. RESULTS: The mean +/- SD
taste scores of the antibiotics as rated by the children were as follows:
amoxicillin-clavulanic acid, 5.7 +/- 3.6 cm; azithromycin, 6.8 +/- 3.2 cm;
clarithromycin, 3.7 +/- 3.6 cm; and erythromycin-sulfisoxazole, 4.9 +/- 3.5
cm. The mean +/- SD taste score for erythromycin-sulfisoxazole (ie, 2.7 +/-
2.3) assigned by the adults was significantly different than that given by
the children (P = .01) with no difference noted for the other 3 drugs.
Children and adults both selected azithromycin most often as best tasting.
There was a significant difference in the proportions selecting each
antibiotic as worst tasting, with the children tending to dislike
clarithromycin and the adults tending to dislike erythromycin-sulfisoxazole
(P = .03). CONCLUSIONS: The taste of azithromycin was rated most highly by
both children and adults, who also selected this antibiotic most often as
best tasting. Differences in taste-testing results between children and
adults suggest that evaluation of the palatability of medications intended
for use in pediatrics should be conducted in children.
