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Title: Comparative study of the effectiveness and pharmacokinetics of two rectal artesunate/oral mefloquine combination regimens for the treatment of uncomplicated childhood falciparum malaria
Authors: Chukiat Sirivichayakul
Arunee Sabchareon
Krisana Pengsaa
Itthipon Thaiarporn
Anong Chaivisuth
Kesara Na-Bangchang
Pataraporn Wisetsing
Pornthep Chanthavanich
Chanathep Pojjaroen-Anant
Thong Pha Phum Hospital
Paholpolpayuhasena Hospital
Thammasat University
Mahidol University
Keywords: Medicine
Issue Date: 1-Mar-2007
Citation: Annals of Tropical Paediatrics. Vol.27, No.1 (2007), 17-24
Abstract: Background: Rectal artesunate has been shown to be an effective treatment for falciparum. malaria and is useful in patients who cannot take medicine orally or when parenteral medication is inconvenient. A combination with mefloquine can decrease the duration of treatment, increase compliance and delay development of resistance. There are no clear data on whether a higher dosage of rectal artesunate results in a better clinical response. Aim: To assess two rectal artesunate/oral mefloquine regimens for treating uncomplicated multi-drug-resistant childhood falciparum. malaria. Methods: Seventy children aged 1-14 years with uncomplicated falciparum malaria were randomly assigned to receive either 10 (range 8-12) or 20 (range 16-24) mg/kg/day rectal artesunate for 3 days followed by 25 mg/ kg oral mefloquine. The study endpoints; were fever clearance time, parasite clearance time and proportion of patients with recrudescence. Serum levels of artesunate and dihydro-artemisinin were measured after the first dose of rectal artesunate in 16 subjects. Results: Both regimens were safe and effective. The cure rate was 100% in the 53 patients who completed 28-day follow-up. All of the study endpoints were comparable between both treatment groups. Conclusion: A regimen of rectal artesunate 10 mg/kg/day for 3 days followed by mefloquine 25 mg/kg is optimal for the treatment of uncomplicated falciparum malaria. There was no definite benefit from increasing the dosage of rectal artesunate from 10 to 20 mg/kg/day. © 2007 The Liverpool School of Tropical Medicine.
ISSN: 02724936
Appears in Collections:Scopus 2006-2010

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