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Title: Artesunate versus artemether in combination with mefloquine for the treatment of multidrug-resistant falciparum malaria
Authors: R. N. Price
F. Nosten
E. Kassa Luxemburger
Am Kham
A. Brockman
T. Chongsuphajaisiddhi
N. J. White
Shoklo Malaria Research Unit
Mahidol University
John Radcliffe Hospital
Keywords: Immunology and Microbiology;Medicine
Issue Date: 1-Jan-1995
Citation: Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.89, No.5 (1995), 523-527
Abstract: To compare the therapeutic efficacy of oral artesunate and artemether in combination with mefloquine for the treatment of mutidrug resistant malaria, a trial was conducted in 540 adults and children on the Thai-Myanmar border. Three regimens were compared: Artesunate (4 mg/kg/d for 3 d), artemether (4 mg/kg/d for 3 d), both in combination with mefloquine (25 mg/kg), and a single dose of mefloquine (25 mg/kg). The artesunate and artemether regimens gave very similar clinical and parasitological responses, and were both very well tolerated. There was no significant adverse effect attributable to the artemisinin derivatives. Fever and parasite clearance times with mefloquine alone were significantly longer (P < 0.001). After adjusting for reinfections the failure rates were 13 9% for the artesunate combination, 12 3% for the artemether combination and 49 2% for mefloquine alone (P < 0 .0001; relative risk 3 8 [95% confidence interval 2 6-5 4]). Mefloquine should no longer be used alone for the treatment of multidrug resistant falciparum malaria in this area. Three-day combination regimens with artesunate or artemether are well tolerated and more effective. © 1995 Oxford University Press.
ISSN: 18783503
Appears in Collections:Scopus 1991-2000

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