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Title: High-dose primaquine regimens against relapse of Plasmodium vivax malaria
Authors: Srivicha Krudsood
Noppadon Tangpukdee
Polrat Wilairatana
Nantaporn Phophak
J. Kevin Baird
Gary M. Brittenham
Sornchai Looareesuwan
Mahidol University
The Asia Foundation
Columbia University, College of Physicians and Surgeons
Keywords: Immunology and Microbiology;Medicine
Issue Date: 1-May-2008
Citation: American Journal of Tropical Medicine and Hygiene. Vol.78, No.5 (2008), 736-740
Abstract: Plasmodium vivax causes debilitating but usually non-lethal malaria in most of Asia and South America. Prevention of relapse after otherwise effective therapy for the acute attack requires a standard daily dose of primaquine administered over 14 days. This regimen has < 90% efficacy in Thailand, and is widely regarded as ineffective because of poor compliance over the relatively long duration of dosing. We evaluated the efficacy, safety, and tolerability of alternative primaquine dosing regimens combined with artesunate among 399 Thai patients with acute, symptomatic P. vivax malaria. Patients were randomly assigned to one of six treatment groups: all patients received artesunate, 100 mg once a day for 5 days. Groups 1-5 then received primaquine, 30 mg a day for 5, 7, 9, 11, and 14 days, respectively. Group 6 received primaquine, 30 mg twice a day for 7 days. The 28-day cure rates were 85%, 89%, 94%, 100%, and 96%, respectively. Treatment of P. vivax malaria with artesunate for 5 days followed by high-dose primaquine, 30 mg twice a day for 7 days, was highly effective, well-tolerated, and equivalent or superior to the standard regimen of primaquine therapy. Copyright © 2008 by The American Society of Tropical Medicine and Hygiene.
ISSN: 00029637
Appears in Collections:Scopus 2006-2010

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