Assessment of the palatability of beta-lactamase-resistant antibiotics in children

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) getting: 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 lasting. 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.