The feasibility of antibiotic dosing four times per day: a prospective observational study in primary health care

Scand J Prim Health Care. 2012 Mar;30(1):16-20. doi: 10.3109/02813432.2012.654196.


Objective: To investigate whether the increase in the number of doses of penicillin V from three times daily to four times daily for common infections, as recommended in the new Norwegian guidelines for antibiotic treatment in primary health care, would lead to reduced patient compliance.

Design: Prospective observational study.

Setting and subjects: Six general practitioners included all patients who were prescribed systemic antibiotic treatment regardless of indication during a 10-month period. A total of 270 patients provided data for the study.

Methods: Telephone interview focusing on omitted antibiotic doses.

Results: Some 17% of patients had poor compliance, defined as failing to take 5% or more of total antibiotic doses. Neither level of poor compliance nor number of omitted doses differed significantly when the number of daily doses increased from three to four. There were significantly fewer omitted doses in the group given two doses per day when compared with three doses (p = 0.04) and four doses per day (p = 0.01).

Conclusion: We found no difference in compliance or omitted doses between antibiotic regimens of three and four doses per day. The new Norwegian guidelines for antibiotic treatment in primary health care appear feasible with regard to patient compliance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / administration & dosage*
  • Child
  • Child, Preschool
  • Drug Administration Schedule
  • Feasibility Studies
  • Female
  • Humans
  • Infections / drug therapy*
  • Male
  • Middle Aged
  • Norway
  • Patient Compliance / statistics & numerical data*
  • Penicillin V / administration & dosage*
  • Practice Guidelines as Topic*
  • Primary Health Care
  • Prospective Studies
  • Young Adult


  • Anti-Bacterial Agents
  • Penicillin V