A comparative clinical trial of artemether and the sequential regimen of artemether-mefloquine in multidrug resistant falciparum malaria

Abstract

A randomized, comparative clinical trial for assessment of the efficacy of two antimalarial regimens, artemether alone and the sequential regimen artemether-mefloquine, was carried out in 109 Thai male patients with acute uncomplicated, multidrug resistant falciparum malaria who were admitted to the Bangkok Hospital for Tropical Diseases. Fifty-three patients received oral artemether at a total dose of 700 mg (300 mg initially, followed by 100 mg daily for 4 days), and 56 patients received the sequential regimen of artemether-mefloquine (300 mg oral artemether initially, followed by 750 mg oral mefloquine after 24 h). Patients in both groups had a rapid initial response to treatment, with a median parasite clearance time of 40 h compared with 43.5 h for the sequential regimen. Median fever clearance times were 42.5 h and 32.5 h for artemether and the sequential regimen respectively. Parasitaemia reoccurred in patients of both groups during the follow up period, six in the artemether and three in the sequential regimen (cure rates were 88 and 94%). No serious adverse effects were observed in either group of patients. © 1995 The British Society for Antimicrobial Chemotherapy.