A multicenter, randomized, comparative assessment in healthy pediatric volunteers of the palatability of oral antibiotics effective in the therapy of otitis media

Objective: The goal of this study was to evaluate the palatability of antimicrobial suspensions effective against beta-lactamase-producing bacteria in a US pediatric population. Background: Compliance with an antibiotic regimen is a key factor in treatment success. Dosing convenience and palatability are believed to be essential aspects of compliance; however, few studies have evaluated the palatability of antimicrobial suspensions in children. Methods: This single-blind, multicenter, randomized, comparative taste test included 4 antimicrobial suspensions: azithromycin (cherry flavored), cefprozil (bubble gum flavored), cefixime (strawberry flavored), and amoxicillin/clavulanate (banana flavored). It was conducted at 3 primary care pediatric centers and involved a volunteer sample of 90 healthy children (5 to 9 years of age). After each antimicrobial test dose, subjects rated its taste on a 10-cm visual analog scale (VAS) incorporating a facial hedonic scale. Assessments of preference for the best- and worst-tasting suspensions were also conducted. Parent surveys regarding the use of antibiotics to treat ear infections were included. Results: Using the VAS, the best-tasting suspension was cefixime (7.3 ± 3.3), compared with azithromycin (6.0 ± 3.8; P < 0.036), cefprozil (5.7 ± 3.5; P < 0.004), and amoxicillin/clavulanate (5.1 ± 3.7; P < 0.0001). More children selected the cefixime and azithromycin preparations as the best-tasting products compared with the others. Cefixime was the least likely to be selected as the worst-tasting product compared with the other suspensions. Parent surveys indicated the following overall features in rank order of importance: antibiotic effectiveness, safety, taste or palatability, dosing convenience (once daily), insurance coverage, cost, and product storage. Conclusion: Among the pediatric population tested, cefixime was most commonly rated as best tasting.