Publication: High-dose mefloquine in the treatment of multidrug-resistant falciparum malaria
Issued Date
1992-01-01
Resource Type
ISSN
15376613
00221899
00221899
Other identifier(s)
2-s2.0-0026489202
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Infectious Diseases. Vol.166, No.6 (1992), 1393-1400
Suggested Citation
F. O. ter Kuile, F. Nosten, M. Thieren, C. Luxemburger, M. D. Edstein, T. Chongsuphajaisiddhi, L. Phaipun, H. K. Webster, N. J. White High-dose mefloquine in the treatment of multidrug-resistant falciparum malaria. Journal of Infectious Diseases. Vol.166, No.6 (1992), 1393-1400. doi:10.1093/infdis/166.6.1393 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/22504
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Title
High-dose mefloquine in the treatment of multidrug-resistant falciparum malaria
Abstract
The therapeutic efficacy and toxicity of a high-dose (25 mg/kg) mefloquine regimen (M25) and the currently recommended regimen of 15 mg/kg (Ml5) were compared in 199 patients with acute falciparum malaria in an area with deteriorating multidrug resistance on the Thai-Burmese border. The clinical and parasitologic responses were significantly more rapid with M25. The incidence of treatment failures by day 7-9 was 7% for Ml 5 and 1% for M25 (P =.03) and had increased to 40% and 9%, respectively, by day 28 (P <.0001). Overall failure rates were highest in children (P =.02). Parasite clearance times were a good predictor of the therapeutic response; all patients with parasitemia persisting >5 days after treatment experienced subsequent recrudescence. Side effects were dose-related and included dizziness, anorexia, nausea, vomiting, and fatigue. Although vomiting <1 h after treatment was more likely in young children, children overall tolerated mefloquine better than adults, and men better than women. The optimum treatment dose of mefloquine in this area is 25 mg/kg. © 1992 the University of Chicago.