Adherence to Prescribed Antibiotic Treatment: A Comparison of Short- vs. Long-Duration from the Perspective of Community Pharmacists

Abstract

Introduction: The main cause of bacterial resistance is the inappropriate use of antibiotics, also known as antibiotic pressure. Lack of patient adherence significantly exacerbates this problem. Recent clinical guidelines suggest shorter courses of antibiotics to improve compliance.

Method: An observational, descriptive, cross-sectional study was conducted. The first phase included the administration of a questionnaire at the time of antibiotic dispensing, while the second phase consisted of a telephone survey conducted 15 days later.

Results: This study was conducted in two pharmacies and involved 400 patients.. Antibiotics prescribed for a duration of 3 days or less were requested 81 times (20.2%), while antibiotics with a longer duration were requested 319 times (79.7%). Our research shows that 184 participants (63.4%) correctly adhered to the prescribed treatment regimen. Adherence increased to 88.9% for short-term treatments, but decreased to 56.4% for treatments longer than three days. Regarding the disposal of leftover antibiotics, for short-term treatments, no antibiotics were left over in 87.3% of cases, 11.1% stored them at home, and 1.6% recycled them at the pharmacy's sigre point. For long-acting antibiotics, 32.6% had no leftover antibiotics, 59% stored them at home, and 8.4% recycled them appropriately.

Conclusions: More than one-third of patients do not adhere to the prescribed antibiotic treatment. The percentage decreases to 11% for courses of 3 days or less, but increases to 56% for longer courses. Optimizing treatment regimens to shorter courses improves adherence. Prescribed antibiotics were adjusted to the required dose in more than 90% of 2- and 3-day courses, while only 22% of long-term courses met this criterion. Aligning antibiotic packaging with therapeutic guidelines is essential to reduce health care and economic costs.