ELECTRONIC COMPLIANCE ASSESSMENT OF ANTIFUNGAL PROPHYLAXIS FOR HUMAN IMMUNODEFICIENCY VIRUS-INFECTED WOMEN

Several prophylactic medications for opportunistic or recurrent infect ions are used in human immunodeficiency virus-infected individuals. Es sential to the efficacy evaluation of these agents is the accurate rep orting of medication compliance, We hypothesized that poor patient com pliance with thrice-weekly fluconazole prophylaxis would correlate wit h the occurrence of clinical events, Fluconazole compliance was monito red electronically by using the Medication Event Monitoring Systems wi th 19 women receiving fluconazole at 50 mg thrice weekly for prophylax is of recurrent mucocutaneous candidiasis, During 202 patient-months o f follow-up, eight breakthrough episodes of mucocutaneous candidiasis developed in four women; compliance data were available for seven of t hese episodes. At 6 months of therapy, more women with greater than or equal to 80% compliance were disease free compared with women with le ss than 80% compliance(P < 0.05; the Fisher exact test), These data su ggest that documentation of medication compliance is essential in stud ies of chronic prophylaxis in human immunodeficiency virus-infected pa tients to properly evaluate drug efficacy and to avoid erroneous concl usions concerning drug failure.