Assessment of the Palatability of Antistaphylococcal Antibiotics in Pediatric Volunteers

OBJECTIVE: To evaluate the palatability of four commonly prescribed antistaphylococcal antibiotics, cloxacillin, cephalexin, erythromycin, and fusidic acid, in volunteer children. DESIGN: A single-blind taste test of four flavored antibiotic suspensions commonly used in the treatment of skin infections in pediatric patients. SETTING: University teaching hospital. PARTICIPANTS: Twenty healthy volunteer children with a mean age of 9.2 +/- 2.0 SD years (range 6-12). MAIN OUTCOME MEASURES: The taste of each antibiotic was rated by the children on a 10-cm visual analog scale incorporating a facial hedonic scale. The children were also asked which antibiotic they thought tasted the best and which tasted the worst. RESULTS: Taste scores were as follows: cloxacillin 1.4 +/- 1.8 cm, cephalexin 6.5 +/- 2.7 cm, erythromycin 6.8 +/- 3.0 cm, and fusidic acid 6.3 +/- 2.4 cm. The taste rating of cloxacillin was significantly lower compared with the other three antibiotics (p = 0.001). Cloxacillin was chosen as having the worst taste by a significant proportion of the children (18 of 20). None of the antibiotics was clearly best tasting. CONCLUSIONS: Given similar effectiveness, taste considerations may be important in the decision as to which antibiotic to prescribe. The perception that cloxacillin is poor tasting to children is supported by this study, which suggests that when compliance with oral medication is critical for successful treatment, prescription of cloxacillin suspension should be avoided.