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Title: Investigations of incidence of pretreatment, drug sensitivity in vitro, and plasma levels of pyrimethamine in patients with multidrug resistant falciparum malaria following the three combination regimens of artemether/pyrimethamine
Authors: Pongsri Tippawangkosol
Kesara Na-Bangchang
Ratawan Ubalee
Kanungnit Congpuong
Jerapat Sirichaisinthop
Juntra Karbwang
Mahidol University
Thailand Ministry of Public Health
Keywords: Medicine
Issue Date: 1-Jun-1999
Citation: Southeast Asian Journal of Tropical Medicine and Public Health. Vol.30, No.2 (1999), 220-224
Abstract: The study was carried out to investigate the status of in vitro susceptibility of Plasmodium falciparum to pyrimethamine (PYR) in multidrug resistant area of the Thai-Myanmar border, the incidence of unregulated use of the combination of PYR with sulfadoxine (Fansidar┬«) in this area and the relevance of pharmacodynamic and pharmacokinetic factors in determining the treatment outcome from the three combination regimens of ART/PYR (1-, 2- and 3-day regimens), in patients with acute uncomplicated falciparum malaria. The majority of patients had baseline PYR concentrations in the range of 1-100 (50.6%) or 100-500 (34.8%) ng/ml, while concentrations of more than 500 ng/ml were found in only 1.1%. All of the isolates exhibited high grade resistance to PYR with the minimum inhibition concentration (MIC) of as high as 10-5 M. No association was observed between treatment outcome and the presence of baseline plasma PYR concentrations. In addition, lack of association between plasma concentrations during the acute phase (day-1 and -2) and treatment outcome was found.
ISSN: 01251562
Appears in Collections:Scopus 1991-2000

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