Publication: Comparative study of the effectiveness and pharmacokinetics of two rectal artesunate/oral mefloquine combination regimens for the treatment of uncomplicated childhood falciparum malaria
Issued Date
2007-03-01
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02724936
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2-s2.0-34447332876
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Mahidol University
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SCOPUS
Bibliographic Citation
Annals of Tropical Paediatrics. Vol.27, No.1 (2007), 17-24
Suggested Citation
Chukiat Sirivichayakul, Arunee Sabchareon, Krisana Pengsaa, Itthipon Thaiarporn, Anong Chaivisuth, Kesara Na-Bangchang, Pataraporn Wisetsing, Pornthep Chanthavanich, Chanathep Pojjaroen-Anant Comparative study of the effectiveness and pharmacokinetics of two rectal artesunate/oral mefloquine combination regimens for the treatment of uncomplicated childhood falciparum malaria. Annals of Tropical Paediatrics. Vol.27, No.1 (2007), 17-24. doi:10.1179/146532807X170466 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/24965
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Title
Comparative study of the effectiveness and pharmacokinetics of two rectal artesunate/oral mefloquine combination regimens for the treatment of uncomplicated childhood falciparum malaria
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Abstract
Background: Rectal artesunate has been shown to be an effective treatment for falciparum. malaria and is useful in patients who cannot take medicine orally or when parenteral medication is inconvenient. A combination with mefloquine can decrease the duration of treatment, increase compliance and delay development of resistance. There are no clear data on whether a higher dosage of rectal artesunate results in a better clinical response. Aim: To assess two rectal artesunate/oral mefloquine regimens for treating uncomplicated multi-drug-resistant childhood falciparum. malaria. Methods: Seventy children aged 1-14 years with uncomplicated falciparum malaria were randomly assigned to receive either 10 (range 8-12) or 20 (range 16-24) mg/kg/day rectal artesunate for 3 days followed by 25 mg/ kg oral mefloquine. The study endpoints; were fever clearance time, parasite clearance time and proportion of patients with recrudescence. Serum levels of artesunate and dihydro-artemisinin were measured after the first dose of rectal artesunate in 16 subjects. Results: Both regimens were safe and effective. The cure rate was 100% in the 53 patients who completed 28-day follow-up. All of the study endpoints were comparable between both treatment groups. Conclusion: A regimen of rectal artesunate 10 mg/kg/day for 3 days followed by mefloquine 25 mg/kg is optimal for the treatment of uncomplicated falciparum malaria. There was no definite benefit from increasing the dosage of rectal artesunate from 10 to 20 mg/kg/day. © 2007 The Liverpool School of Tropical Medicine.