Publication: Pharmacokinetic properties of artemether, dihydroartemisinin, lumefantrine, and quinine in pregnant women with uncomplicated plasmodium falciparum malaria in uganda
Issued Date
2013-10-01
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ISSN
10986596
00664804
00664804
Other identifier(s)
2-s2.0-84884243319
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Mahidol University
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SCOPUS
Bibliographic Citation
Antimicrobial Agents and Chemotherapy. Vol.57, No.10 (2013), 5096-5103
Suggested Citation
Joel Tarning, Frank Kloprogge, Mehul Dhorda, Vincent Jullien, Francois Nosten, Nicholas J. White, Philippe J. Guerin, Patrice Piola Pharmacokinetic properties of artemether, dihydroartemisinin, lumefantrine, and quinine in pregnant women with uncomplicated plasmodium falciparum malaria in uganda. Antimicrobial Agents and Chemotherapy. Vol.57, No.10 (2013), 5096-5103. doi:10.1128/AAC.00683-13 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/32149
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Title
Pharmacokinetic properties of artemether, dihydroartemisinin, lumefantrine, and quinine in pregnant women with uncomplicated plasmodium falciparum malaria in uganda
Abstract
Pregnancy alters the pharmacokinetic properties of many drugs used in the treatment of malaria, usually resulting in lower drug exposures. This increases the risks of treatment failure, adverse outcomes for the fetus, and the development of resistance. The pharmacokinetic properties of artemether and its principal metabolite dihydroartemisinin (n=21), quinine (n=21), and lumefantrine (n = 26) in pregnant Ugandan women were studied. Lumefantrine pharmacokinetics in a nonpregnant control group (n=17) were also studied. Frequently sampled patient data were evaluated with noncompartmental analysis. No significant correlation was observed between estimated gestational age and artemether, dihydroartemisinin, lumefantrine, or quinine exposures. Artemether/ dihydroartemisinin and quinine exposures were generally low in these pregnant women compared to values reported previously for nonpregnant patients. Median day 7 lumefantrine concentrations were 488 (range, 30.7 to 3,550) ng/ml in pregnant women compared to 720 (339 to 2,150) ng/ml in nonpregnant women (P=0.128). There was no statistical difference in total lumefantrine exposure or maximum concentration. More studies with appropriate control groups in larger series are needed to characterize the degree to which pregnant women are underdosed with current antimalarial dosing regimens. Copyright © 2013, American Society for Microbiology. All Rights Reserved.