Publication: Artesunate versus artemether for the treatment of recrudescent multidrug-resistant falciparum malaria
4
Issued Date
1998-01-01
Resource Type
ISSN
00029637
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2-s2.0-0032429282
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Mahidol University
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SCOPUS
Bibliographic Citation
American Journal of Tropical Medicine and Hygiene. Vol.59, No.6 (1998), 883-888
Suggested Citation
Ric Price, Michele Van Vugt, François Nosten, Christine Luxemburger, Alan Brockman, Lucy Phaipun, Tan Chongsuphajaisiddhi, Nicholas White Artesunate versus artemether for the treatment of recrudescent multidrug-resistant falciparum malaria. American Journal of Tropical Medicine and Hygiene. Vol.59, No.6 (1998), 883-888. doi:10.4269/ajtmh.1998.59.883 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/18419
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Title
Artesunate versus artemether for the treatment of recrudescent multidrug-resistant falciparum malaria
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Abstract
The therapeutic efficacy and toxicity of artesunate (2mg/kg/day for five days, then 1 mg/kg/day for two days: total = 12 mg/kg) was compared with that of artemether (4 mg/kg followed by 2 mg/kg/day for two days, then 1 mg/kg/day for four days: total = 12 mg/kg) for the treatment of recrudescent multidrug- resistant falciparum malaria in an open randomized trial in 443 patients living on the western border of Thailand. Parasite and fever clearance times were similar in both groups; within 48 hr 94% (95% confidence interval [CI] = 91-96%]) of the treated patients were aparasitemic and 93% (95% CI = 89-96%) were afebrile. Symptom resolution and resolution of hepatomegaly were slightly slower in the artesunate group; adjusted hazards ratio = 1.5 (95% CI = 1-2.0, P < 0.01) and 2.2 (95% CI = 1.4-8, P = 0.04), respectively. There was no significant difference in times to resolution or development of anemia or splenomegaly between treatment groups. By day 28, 3% (95% CI = 0.3-5%) of the patients treated with artesunate and 6% of those treated with artemether (95% CI = 2-9%) had recurrent infections (P = 0.3). Both regimens were very well tolerated, with no significant adverse effects attributable to either derivative. Overall, these data suggest that the two oral artemisinin derivatives are safe, highly effective, and result in equivalent therapeutic responses in the treatment of drug-resistant falciparum malaria.