Publication: Treatment of multidrug-resistant plasmodium falciparum malaria with 3-day artesunate-mefloquine combination
Issued Date
1994-01-01
Resource Type
ISSN
15376613
00221899
00221899
Other identifier(s)
2-s2.0-0028106706
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Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Infectious Diseases. Vol.170, No.4 (1994), 971-977
Suggested Citation
F. Nosten, C. Luxemburger, F. O. Ter Kuile, C. Woodrow, J. Pa Eh, T. Chongsuphajaisiddhi, N. J. White Treatment of multidrug-resistant plasmodium falciparum malaria with 3-day artesunate-mefloquine combination. Journal of Infectious Diseases. Vol.170, No.4 (1994), 971-977. doi:10.1093/infdis/170.4.971 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/9852
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Title
Treatment of multidrug-resistant plasmodium falciparum malaria with 3-day artesunate-mefloquine combination
Abstract
Studies of 652 adults and children with acute uncomplicated falciparum malaria were done to determine the optimum treatment of multidrug-resistant Plasmodium falciparum malaria on the Thai-Burmese border. Single-dose artesunate (4 mg/kg) plus mefloquine (25 mg of base/kg) gave more rapid symptomatic and parasitologic responses than high-dose mefloquine alone but did not improve cure rates. Three days of artesunate (total dose, 10 rug/kg) plus mefloquine was 98% effective compared with a 28-day failure rate of 31% with high-dose mefloquine alone (relative risk [RR], 0.06; 95% confidence interval [CI] , 0.02-0.2; P < .0001). By day 63, the reinfection adjusted failure rates were 2% and 44%, respectively (P.0001). Artesunate also prevented high-grade failures. Both drugs were well tolerated. No adverse effects were attributable to artesunate. Vomiting was reduced significantly by giving mefloquine on day 2 of treatment (RR, 0.40; 95% CI, 0.20-0.79; P =.009. Artesunate (10 mg/kg over 3 days) plus mefloquine (25 mg/kg) is currently the most effective treatment for falciparum malaria in this area of increasing mefloquine resistance. © 1994 by The University of Chicago.