Geletko S M, Segarra M, Mayer K H, Fiore T C, Bettencourt F A, Flanigan T P, Dudley M N
Department of Pharmacy Practice, University of Rhode Island College of Pharmacy, Kingston 02881-0809, USA.
Antimicrob Agents Chemother. 1996 Jun;40(6):1338-41. doi: 10.1128/AAC.40.6.1338.
Several prophylactic medications for opportunistic or recurrent infections are used in human immunodeficiency virus-infected individuals. Essential to the efficacy evaluation of these agents is the accurate reporting of medication compliance. We hypothesized that poor patient compliance with thrice-weekly fluconazole prophylaxis would correlate with the occurrence of clinical events. Fluconazole compliance was monitored electronically by using the Medication Event Monitoring Systems with 19 women receiving fluconazole at 50 mg thrice weekly for prophylaxis of recurrent mucocutaneous candidiasis. During 202 patient-months of follow-up, eight breakthrough episodes of mucocutaneous candidiasis developed in four women; compliance data were available for seven of these episodes. At 6 months of therapy, more women with greater than or equal to 80% compliance were disease free compared with women with less than 80% compliance (P < 0.05; the Fisher exact test). These data suggest that documentation of medication compliance is essential in studies of chronic prophylaxis in human immunodeficiency virus-infected patients to properly evaluate drug efficacy and to avoid erroneous conclusions concerning drug failure.
几种用于预防机会性感染或复发性感染的药物被用于感染人类免疫缺陷病毒的个体。准确报告药物依从性对于评估这些药物的疗效至关重要。我们假设患者对每周三次氟康唑预防用药的依从性差与临床事件的发生相关。通过使用药物事件监测系统对19名接受每周三次50毫克氟康唑预防复发性黏膜皮肤念珠菌病的女性进行电子监测氟康唑的依从性。在202个患者月的随访期间，4名女性出现了8次黏膜皮肤念珠菌病突破性发作；其中7次发作有依从性数据。在治疗6个月时，依从性大于或等于80%的女性中无疾病的人数多于依从性小于80%的女性（P<0.05；Fisher精确检验）。这些数据表明，在对感染人类免疫缺陷病毒患者进行慢性预防研究时，记录药物依从性对于正确评估药物疗效以及避免关于药物治疗失败的错误结论至关重要。
