Clinical Case 040: Quit QID?

This is a quickie.

My 2 yo recently developed a purulent toenail / cellulitis / paronychia.  So we decided to start him on some oral ABs – it is always staph – so flucloxacillin seemed like a good option.

Now in this case series of n=1, where both parents are highly-trained medical professionals, have good insight into the pharmacodynamics and were highly motivated to comply with the prescribed treatment regime.  Here is the outcomes:

Mum’s days = average 2.2 doses out of the recommended 4 completed

Dad’s days = average 1.7 doses out of 4 completed.

So what conclusions can I draw from this slightly underpowered, retrospective, case-series study.  Well I think there are 2 possibilities:

  1. I am a bad parent
  2. Prescribing QID medicine (to kids in particular) is a futile exercise.

I have long held this suspicion (option 2, that is), but not until this week did I have the chance to do a real-world trial – and I have to say, I think that it is nigh on impossible to do QID in vivo.

Love to hear your thoughts.  I think I will change to meds which are TDS at worst, BD even better.




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