F. NostenC. LuxemburgerF. O. Ter KuileC. WoodrowJ. Pa EhT. ChongsuphajaisiddhiN. J. WhiteMahidol UniversityAcademic Medical Centre, University of AmsterdamJohn Radcliffe HospitalAmsterdam Medical CentreSt Mary's Hospital London2018-02-272018-02-271994-01-01Journal of Infectious Diseases. Vol.170, No.4 (1994), 971-97715376613002218992-s2.0-0028106706https://repository.li.mahidol.ac.th/handle/20.500.14594/9852Studies 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.Mahidol UniversityMedicineArticleSCOPUS10.1093/infdis/170.4.971