Publication: Randomized comparison of mefloquine-artesunate versus quinine in the treatment of multidrug-resistant falciparum malaria in pregnancy
Issued Date
2000-01-01
Resource Type
ISSN
00359203
Other identifier(s)
2-s2.0-0033659429
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.94, No.6 (2000), 689-693
Suggested Citation
Rose McGready, Alan Brockman, Thein Cho, Dju Cho, Michele Van Vugt, Christine Luxemburger, Tan Chongsuphajaisiddhi, Nicholas J. White, François Nosten Randomized comparison of mefloquine-artesunate versus quinine in the treatment of multidrug-resistant falciparum malaria in pregnancy. Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.94, No.6 (2000), 689-693. doi:10.1016/S0035-9203(00)90235-9 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/26013
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Randomized comparison of mefloquine-artesunate versus quinine in the treatment of multidrug-resistant falciparum malaria in pregnancy
Abstract
Since no effective malaria prevention measures have been identified for pregnant women living on the western border of Thailand, prompt diagnosis and efficient treatment are paramount, although drug resistance in Plasmodium falciparum has narrowed the treatment options. An open randomized comparison of supervised quinine (10 mg salt/kg every 8 h) for 7 days (Q7) versus mefloquine 25 mg base/kg (total dose) plus artesunate 4 mg/kg per day for 3 days (MAS3) was conducted in 1995-97 in 108 Karen women with acute uncomplicated falciparum malaria in the second or third trimesters of pregnancy. The MAS3 regimen was more effective than the Q7 regimen: day 63 cure rates were 98.2% (95% CI 94.7 - 100) (n=65) for MAS3 and 67.0% (95% CI 43.3-90.8) (n=41) for Q7, P=0.001. The MAS3 regimen was also associated with less gametocyte carriage; the average person-gametocyte-weeks for MAS3 was 2.3 (95% CI 0-11) and for Q7 was 46.9 (95% CI 26-78) per 1000 person-weeks, respectively (P<0.001). MAS3 was significantly better tolerated. These evident advantages must be balanced against a possible increased risk of stillbirth with the use of mefloquine in pregnancy. Further randomized studies assessing the safety and efficacy of other artemisinin-containing combination regimens in pregnancy are needed urgently.